What are the risks of taking estrogen in surgical menopause?
In surgical menopause, there is no evidence that using estrogen increases risk of cancer, blood clot, or stroke.
Note that this is different from the risks you might have heard about with estrogen therapy in the natural menopause (where continued production of some ovarian hormones persists through 80 years old).
Large studies of estrogen in surgical menopause completed in both America and Denmark have demonstrated that long-term estrogen ( 5+ years) may actually reduce risk for cardiovascular disease and breast cancer, and does not appear to alter risk of blood clots or stroke.
In the case of breast cancer, studies suggest that estrogen does not increase risk of breast cancer when used in surgical menopause, even among those who are BRCA1 or BRCA2 carriers provided they do not have a personal history of cancer. In those in surgical menopause who have a Factor V Leiden mutation (which increases risks for blood clots), the long-term protective effects of hormone therapy may often outweigh the risks posed by the use of hormones.
Nevertheless, if you are concerned about using estrogen due to a family history of estrogen-dependent cancers, blood clots, or other risks, it is wise to discuss this with your doctor to make sure that you are carefully dosed and monitored to avoid adverse effects of hormones in surgical menopause. Alternative medications can also be used in some extreme cases (e.g., in patients with current estrogen-positive cancers)
Of note, there is no evidence that hormone therapy causes weight gain.
More reading: www.iapmd.org/estrogen-therapy
Visit www.iapmd.org/surgery for lots of evidence-based information and resources for those considering, going through or recovering from surgery for PMDD/PME.