A study done by Mayo Clinic researchers found that women who had both of their ovaries surgically removed had twice the risk of developing Parkinson’s disease later in life. The risk doesn’t come from the surgery itself, but from the decreased levels of estrogen.

There is evidence from animal studies that estrogen protects the part of the brain involved in controlling movement. Damage to this part of the brain can result in Parkinson’s disease. A newer study involving nearly 5000 women shows a similar protective property of estrogen in humans. About 1/4 of the women had one ovary removed, 1/4 had both ovaries removed and the remaining 1/2 had not undergone surgery. Women who had both ovaries removed had twice the risk of developing Parkinson’s disease as women who still had both ovaries. Those retaining one ovary had only a slight increase in risk.

Women considering having their ovaries removed as a preventative measure or with a hysterectomy should weigh their options carefully. If you have ovarian cancer, obviously you should have your ovaries removed. For many other conditions, having a hysterectomy while keeping your ovaries may be a good option. Keeping your ovaries will allow them to continue to make estrogen, thereby protecting your bones from osteoporosis, your heart from cardiovascular disease and your brain from Parkinson’s disease.

Estrogen can help lower cardiovascular risks, if it is given at the right time. An 8 year study called the WHI-CACS trial showed that estrogen is cardioprotective in younger post-menopausal women. Women who started hormone therapy in their 50’s, typically before advanced atherosclerosis develops, were 61% less likely to have high levels of coronary calcification (hardened plaque build-up in the coronary arteries) than those women who had not taken hormones.

Starting hormone therapy when a women is older, say 10-15 years post-menopausal and more likely to have advanced atherosclerosis, is not cardioprotective. In fact, it could increase cardiovascular risk due to thrombosis (formation of a clot in your artery or vein) and plaque rupture, which can close an artery within hours (as opposed to closure by atherosclerosis, which can take months or years) resulting in a heart attack.

Hormone therapy has many benefits other than relief from hot flashes, but it is important to work with a knowledgeable physician to decide which hormones are right for you and how long you should take them. Relief from the symptoms of menopause, which are quality of life issues, can go hand-in-hand with preventive medicine such as cardioprotection and protection from osteoporosis.

Finding a lump in your breast can be scary. Fortunately, 80% of breast lumps turn out to be benign-not dangerous. What can you expect after finding a lump?

First, your physician will want to do a clinical breast exam. After ruling out the obvious, like bug bites and swollen lymph nodes, your physician will order tests to determine what the lump is. Here are some of the tests they will be considering:

• Diagnostic mammogram-Your breast will be x-rayed from a variety of angles to get a clear view of the area of concern. Digital mammograms are typically more accurate than analog mammograms-especially for premenopausal women and women with dense breasts.
• Ultrasound-Your breast may be viewed using a wand-like device that emits high-frequency sound waves. An ultrasound can distinguish a fluid-filled cyst from a solid mass.
• MRI (magnetic resonance imaging)-A dye is introduced into the veins of the breast creating a 3-D image of the breast on a screen. Distinguishing different types of tissue is then fairly easy…normal tissue looks different than cysts and tumors. MRI is a good option for women with breast implants and women who have already had breast cancer.
• Breast biopsy-If non-invasive tests are inconclusive, your physician may order a breast biopsy. A small sample of tissue will be removed from the area of concern to be examined further. You may have a fine-needle biopsy if your lump can be felt, but not seen on film; a core-needle biopsy for solid lumps or masses; or an excisional biopsy, during which the entire lump is removed in the hospital while you are under sedation.

Whichever test your physician chooses, it is important for you to have the additional tests necessary to protect your health. While 80% of lumps are benign, don’t assume yours is-follow up on it and be sure.

The colonoscopy is the most comprehensive test available to screen for polyps (which can turn into cancer) and cancers of the rectum and colon. Your doctor will order a colonoscopy as a screening test around your 50th birthday.

The day before the test, you will be asked to follow a clear liquid diet. You’ll have to take laxatives beforehand, and possibly have an enema the day of the test. This ensures that no stool blocks the view of the colon.

During the test, the doctor uses a lighted instrument called a colonoscope to examine the entire length of the colon and the rectum. This usually takes 20-30 minutes and is done under sedation in an outpatient facility or hospital.

There is a slight risk of bleeding or tears in the lining of the colon, but the benefits outweigh the risks, with a cancer detection rate of over 90%. If a polyp or early cancer is found, it can be removed during the procedure.

The colonoscopy is an important tool your doctor uses to prevent colon cancer or detect it at an early, curable stage. Talk to your doctor about how often the colonoscopy needs to be done-many doctors recommend once every 10 years.

Several years ago, women were told that estrogen was dangerous and contributed to heart attacks and strokes. All women were advised to discontinue hormone therapy until further notice. That notice has been given. After continuing to analyze data from the original studies…scientists have determined that women starting hormones shortly after menopause actually have a lower risk of heart disease. Specifically, taking estrogen for 7 years or more after menopause reduces calcification of the arteries by as much as 60%. Calcification of the arteries is a predictor of increased risk of heart attack. The only women found to be at risk were those who started hormone therapy at least 10 years after menopause.

The original studies (such as the Women’s Health Initiative study) included a number of older women who are rarely considered candidates for hormone replacement therapy. This unfortunate selection of subjects caused skewed results that don’t apply to the average menopausal women seeking relief from hot flashes and night sweats. As Dr. Robert W. Rebar, executive director of the American Society for Reproductive Medicine, states: “We are clearly learning that the benefits of estrogen in young, healthy, symptomatic post-menopausal women outweigh the risks.”

Estrogen, like any other medication or hormone, should be given in doses appropriate for you and monitored regularly. Hormones can help ease your transition through menopause.