Sue:
I understand Eli- Lily the pharmaceutical company that makes Evista has begun a 10 year study of Evista. At this time what do we know about any heart protection that Evista would give a woman?

Dr. Goldstein:
Ruth (Raloxifen Use in The Heart) is a long term study of the effects of Evista on coronary artery disease both primarily and secondarily. Currently, one can say that there is a 10-15% reduction in total cholesterol and LDL cholesterol which most experts feel account for about 30% of coronary artery heart disease risk. Beyond that, one cannot say anything more directly although with the recent study, it becomes difficult to say much about continuous combined hormone replacement therapy (at least in terms of Premarin and medroxy progesterone acetate).

Sue:
What, in your opinion, is the most compelling reason for a post menopausal woman to take a SERM like Evista as opposed to some estrogen/progesterone product?

Dr. Goldstein:
The most compelling reason for postmenopausal women to take a SERM like Evista would be when the patient is interested in extending long term health benefits, especially if they do not already have osteoporosis and especially if one of their prime concerns is breast cancer or fear of breast cancer. As I stated in the first question, one must distinguish women who want relief of symptoms of the transition from those women looking to extend postmenopausal women's health.

Sue:
Evista doesn't eliminate hot flashes, in fact one of its side effects is hot flashes. Is Evista still an option for women who have a long history of vasomotor symptoms like hot flashes and heart palpitations?

Dr. Goldstein:
Evista is not really an option for women who have a long history of vaso-motor symptoms like hot flashes and heart palpitations. In my experience, 80-90% of women will be over such symptoms within 12-30 months of entering menopause. Occasionally women will have such symptoms that will last much longer. In addition, some women who went on HRT for relief of symptoms may find that by tapering their estrogen and then discontinuing for one month, if they do not have any resumption in hot flashes, they may be excellent candidates to begin Evista for promoting long term health benefits.

The Benefits of Estrogen

Sue:
Estrogen has over 300 known functions in a woman's body. In your book The Estrogen Alternative it seems obvious that Evista's anti cancer claims are attractive to say the least. But aren't there women who actually benefit from estrogen, beyond bone protection?
See the answer to this question

Meet the author
Linda Ojeda, Ph.D
"Her Healthy Heart" &
"Menopause Without Medicine"
interview & FREE excerpt
Alcohol: The Double Edged Sword
In her latest book, Her Healthy Heart, Linda again is in front of the health pack.  She rings the warning bell for all women to wake up and recognize that heart disease is as big a problem for women as it is for men.  Not only do women have a six times greater chance of dying from heart disease when compared with deaths  from  breast cancer, women are often misdiagnosed and do not receive the proper heart care. Her Healthy Heart is filled with practical and useful ways for women to keep their hearts healthy and prevent heart disease.  She also provides natural ways to prevent and reverse heart disease.

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