Estrogen thus appears to be a contradictory molecule, both essential and harmful to women. Because of the dual nature of the effects of estrogen, researchers are actively seeking to identify so-called designer estrogens, chemicals that are known technically as selective estrogen receptor modulators (SERM). These substances would behave like estrogen in some tissues but block its actions in others. It is possible that one such compound, raloxifine, now prescribed for maintaining bone density in older women, may be able to protect women from osteoporosis and coronary artery disease as well as endometrial and breast cancer. Long-term studies with this and other SERMs in development may be able to protect women single-handedly from the multiple disorders that increase in prevalence after menopause. For the time being, however, each woman must weigh the known risks and benefits of the available forms of HRT and, together with information and advice from health care providers that takes into account her own health history, make her personal decision regarding whether or not to initiate HRT at the time of menopause.
RITA B. EFFROS
AUSTAD, S. A. Why We Age. New York: John Wiley & Sons, 1997.
BELLANTONI, M. F., and BLACKMAN, M. R. "Menopause and Consequences." In Handbook of the Biology of Aging. Edited by E. Schneider and J. Rowe. San Diego: Academic Press, Inc., 1996. Pages 415–430.
GREENDALE, G. A.; LEE, N. P.; and ARRIOLA, E. A. "The Menopause." Lancet 353 (1999): 571–580.
GRODSTEIN, F.; STAMPFER, M. J.; COLDITZ, G. A.; WILLETT, W. C.; MANSON, J. E.; JOFFE, M.; ROSNER, B.; FUCHS, C.; HANKINSON, S. E.; HUNTER, D. J.; HENNEKENS, C. H.; and SPEIZER, F. E. "Postmenopausal Hormone Therapy and Mortality." New England Journal of Medicine 336 (1997): 1769–1775.
JORDAN, V. C. "Designer Estrogens." Scientific American, October 1998, pp. 60–67.
MOSCA, L. M.; COLLINS, P.; HERRINGTON, D. M.; MENDELSOHN, M. E.; PASTERNAK, R. C.; ROBERTSON, R. M.; SCHENCK-GUSTAFSSON, K.; SMITH, S. C.; TAUBERT, K. A.; and WENGER, N. K. "Hormone Replacement Therapy and Cardiovascular Disease: A Statement for Health-care Professionals from the American Heart Association." Circulation 104 (2001): 499–503.
WISE, P. M.; KRAJNAK, K. M.; and KASHON, M. L. "Menopause: The Aging of Multiple Pacemakers." Science 273 (1996): 67–70.