And Riciu- you appear to be a Dude arguing with women about HRT & POF. As I see no MD after your name- WTH qualifies you to argue reproductive health and safe estrogen levels? Arguing for the sake of arguing is of ZERO contribution for women actually living with this.

“Data in young women with spontaneous premature ovarian failure argues against an increased risk of breast cancer or other adverse events with full replacement doses. [64]”

64. Christin-Maitre S. The role of hormone replacement therapy in the management of premature ovarian failure. Nat Clin Pract Endocrinol Metab. 2008;4:60–61. [PubMed]

You are not denying that low levels of natural hormones decrease breast cancer risk. HRT increases breast cancer risk. But you don’t know and you cannot determine it from the studies of older women whether the increase of risk with HRT exceeds the decrease in risk from losing natural hormones early. I.e. you don’t know if a woman with POF taking HRT up to the age of 50 has higher breast cancer risk than a woman who goes into the menopause at the age of 50. You don’t know it. No studies has shown the greater increase in risk with HRT than with natural hormones. Yet by listing the breast cancer risk as one of the risks of POF ( because of the HRT use) – something no other source does, your article implying that it is the case.

This has always been my main problem with this article. This is by the way what the researcher/doctor who’s studies POF at NIH thinks about POF management — he addresses the risks at one point as well as dosage.
https://poi.nichd.nih.gov/pdf/MenopauseManagement.pdf

Best Regrads, Riciu Andrei

2. I am not denying that low levels of these hormones decrease cancer risks, that is a medical fact, what i am trying to make you understand is that, theory and practice differ. Medical practice can not get even close to a healthy endocrine system (this has nothing to do with any study), and the doses may be higher that is the whole point. And i can see you already now that higher levels of those hormones increase cancer risk.

Best Regards, Riciu Andrei

2. I know very well that HRT doesn’t replace a normal menstruation or perfectly mimic a normal function – I am not as stupid or ignorant as you may think. However, in terms of breast cancer risk, it’s well known (do you deny it?) that a) later natural menopause increases risk of breast cancer b) earlier menopause decreases risk of breast cancer and c) removing ovaries in a pre-menopausal women at high risk of breast cancer greatly decreases risk of breast cancer. All of this is very well documented, but if you wish I could easily find the relevant research.

DO YOU DENY THAT EARLY LOSS OF OVARIAN FUNCTION DECREASES BREAST CANCER RISK? DID YOU BOTHER TO COMPARE THE RISK INCREASE WITH HRT BEFORE IMPLYING THAT THE RISK INCREASE IS GREATER WITH HRT?

3. there are studies that estimate the percentage of risk increase with late menopause (or decrease with early menopause) per year and there are studies that estimate the risk increase with HRT per year of use, it’s relatively easy to compare numbers. As of today NOBODY has shown that the additional risk increase with HRT is greater than that of additional years of natural hormones.

What you are implying in your article by mentioning that women with POF is at greater risk of breast cancer than women the same age that are still menstruating when in fact this has never been shown. ALL HRT studies including WHI or anything else only looked at menopausal women and compared risks of menopausal women on HRT to menopausal women on placebo. It also looked at older women, the average age in WHI was around 60. Not only younger women have a significantly lower breast cancer risk to begin with (which means that ABSOLUTE risk increase is less), but more importantly you cannot extrapolate from the research comparing menopausal women to

4. I know that doctors aren’t gods, and I might not have gone to medical school – although evaluating studies has always been done by epidemiologists than doctors and epidemiology is largely statistics and my knowledge of math/statistics is no less than yours given as I have a math degree – but I got my information a) from doctors who not only gone to medical school but who spent most of the time after that studying specifically POF like for example Dr Lawrence from NIH and b) at one point in the past I sent an e-mail directly to doctors who run WHI trial, and their reply was along the lines of what I posted. They actually included numbers, but I no longer have this email.

Maybe instead of talking down to me you should actually look at the studies and evaluate the data?

Firstly i stated “the lowest EFFECTIVE dose” and not the lowest possible dose. And effective means protection as far as i know.
Secondly, please understand that HRT can not replace a normal menstruation and that HRT will never perfectly mimic a normal hormonal function!!! Hormone replacement therapy will always have “adverse effects” as it is not a normal body endocrine secretion (the doses used in practice can not be exactly what the body needs in that certain moment , may be higher, may be lower).The exact and ideal dose is almoast impossible to achieve in practice . The normal body has several complex mechanisms used to regulate normal hormonal secretion. DOCTORS ARE NOT GODS! Can you understand that? Therefore there are some increased risks…one of them is breast cancer. Maybe you should try medical school, in order to understand those studies better.
Best Regards, Riciu Andrei