About 25 percent of postmenopausal women in the United States take estrogen replacement therapy because of evidence that it protects against osteoporosis and heart disease. Even more of these women feel free to have a drink now and then because of research showing that it, too, may protect against heart disease.
But a new study raises a host of questions about the long-term health consequences of drinking even small amounts of alcohol while taking the hormone therapy.
The study found that when postmenopausal women on oral estrogen drank the equivalent of just half a glass of wine, the levels of estrogen circulating in their blood nearly doubled, on average. After a drink comparable to three glasses of wine, estrogen surged more than threefold.
One of the most significant questions raised by the new study is what, if any, effect the striking rise in estrogen has on a woman's risk of breast cancer.
Studies show that estrogen therapy protects against heart disease and osteoporosis but may increase the risk of breast cancer. Some research also shows that moderate alcohol consumption -- one drink a day for a woman -- may decrease the risk of heart disease but increase the risk of breast cancer, as well. The breast cancer findings are the subjects of medical dispute.
The study is the first one to look at the effects of alcohol on oral estrogen replacement therapy. "I was surprised to see estrogen levels rise so much," said Dr. Elizabeth S. Ginsburg, the lead author of the report and an assistant professor of obstetrics, gynecology and reproductive medicine at Harvard Medical School.
Dr. Howard L. Judd, vice chairman of the department of obstetrics and gynecology at the University of California at Los Angeles School of Medicine, said that some increase in estrogen after a drink was to be expected based on previous findings that alcoholic men had elevated levels of estrogen. But he said, "I was surprised by the magnitude of the change."
The new study, which appears today in the Journal of the American Medical Association, suggests that "alcohol may increase the beneficial as well as the detrimental effects of estrogen therapy," said Dr. Wulf H. Utian, director of obstetrics and gynecology at the University Hospitals of Cleveland and an expert on menopause.
The two-day study compared 12 healthy postmenopausal women taking estrogen replacement therapy with 12 who were not receiving the therapy.
Pub Date: 12/04/96