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Question of the Month

Q: I am 45 years old and have recently been experiencing hair loss. My physician prescribed Premphase to alleviate the hair loss. I haven't started taking the medication because of the many concerns I have regarding increased risks for breast cancer, heart disease, and blood clots. My doctor has assured me that there are relatively few risks for women who take hormone replacement therapy for less than five years. My question for you is, if I experience decreased hair loss while taking this medication, what will happen when I stop taking it at the end of the five years? Will my hair start falling out again?


A: My newsletter is available by email and the October 2002 issue discusses the new study on hormone replacement (Making Sense of HRT). Decisions need to be made on an individual basis. There is much evidence that whatever risk exists of breast cancer, it does not start to go up for 4 or 5 years after starting HRT.

If HRT helps hair, it is of course possible that stopping it in 4 years will cause shedding to resume. I am hopeful however that at that time we will have more complete information about other forms of HRT and so there may be better information to base the decision on.

I cannot make specific treatment recommendations for anyone over the web. However my general feeling is that since Prempro was the form of HRT used in the WHI study, it probably should be avoided. It comes from horses and contains forms of estrogen which are not normally present in women's bodies. I generally recommend estradiol, the normal human estrogen in pill or patch form, and natural progesterone capsules (the brand name is Prometrium).

Any woman considering a change regarding HRT should discuss it first with her physician.

Hope this is helpful.

Sincerely,

Geoffrey Redmond, MD


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