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The Estrogen Window

Book Review:
The Estrogen Window

Estrogen Window-Seibel
Mache Seibel, MD
Rodale Press, April 2016
237 pages

Dr. Mache Seibel writes a book for patients and medical providers on the topic of treatment with hormone therapy. He attempts to take the fear out of estrogen. He wants women to know that those who are currently treating their symptoms with estrogen are not exposing themselves to serious risks and that those women who are considering estrogen therapy understand what he calls The Estrogen Window.

The window is a period of time in which estrogen poses minimal risks and provides maximum benefit. After that window closes, outcomes change, and estrogen can expose a woman to lesser benefits with potentially much greater risks. The author encourages women to consider the estrogen window to better the chance of improving quality of physical and mental health rather than to endure all of the unpleasant symptoms of menopause.

This book takes on the Women’s Health Initiative (WHI) and the controversy that was amplified by the press. The media is faulted for remarkable silence on the subsequent reversal of thinking during the last few years as the results of better-designed studies of the risks and benefits of estrogen have been published. These studies were more positive toward the benefits of estrogen. The following benefits are explained in detail throughout the book:

   • Extended protection from myocardial infarction and heart failure
   • Reduced risk of Alzheimer disease and other forms of cognitive decline
   • Reduced risk of osteoporosis
   • Reduced risk of type 2 diabetes
   • Beneficial cosmetic effects on structure and resiliency of skin
   • Relief of vaginal dryness and painful intercourse
   • Relief from troubling and sometimes disabling hot flashes
   • Improved quality of sleep
   • Stabilized mood, especially in women with a known mental health diagnosis
   • Support for bladder tissue and reduced risk of recurring urinary tract infections

These advantages are clearly demonstrated throughout the book if estrogen is taken during a woman’s estrogen window. The duration her window stays open depends on two factors: which estrogen-containing medicine is used, and which symptom or condition is being targeted. If the same woman takes the same drug outside her estrogen window, there may be an increased risk of serious side effects. The author explains that it is the medroxyprogesterone used in the WHI that is the bad actor.

This book describes the irony of treating women who are afraid of developing heart disease and other serious diseases if they use estrogen. They are greatly protected against developing these deadly conditions after menopause. The book is informative, current, and quite detailed. At times I feel that more information is given to healthcare consumers than they can fully comprehend, but on the contrary it enables them to participate in their treatment decisions with an educated mind. The book also encourages women to find the right healthcare provider through the NAMS Certified Menopause Practitioners listing on its website. It encourages the patient to come to her appointment with a notebook and/or a friend or a tape recorder. It also encourages questioning, keeping a list of symptoms, and making sure that the appointment is not rushed. Pelvic examination and lab tests are also discussed. He leaves nothing out of this wonderful book.

If a woman wants more information than the book provides, she can go to www.estrogenwindowbook.com and read about issues such as urinary incontinence, other treatments for hot flashes, a sleep diary, and how to wean off hormone therapy.

I thought this was a beautifully written book, and I will encourage my resident and student trainees to read it. This will be essential reading for the teaching program at my hospital.

Robyn B Faye, MD, FACOG, NCMP, IF
Previous Chairman Consumer Education Department
Clinical Assistant Professor at Drexel University in the Physician’s Assistant Department
Abington-Jefferson Health
Abington Primary Women’s Healthcare Group
Abington, Pa

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