Got a phone call yesterday from a friend worried about her mother, who is in the hospital. This 82 year old lady has multiple health issues, among them an enlarged heart and cardiac arrhythmia problems. In simple terms, her heart has had to work too hard and gotten too big, and the electrical signals that should make her heart beat normally are not firing properly. It's a lot like having an electricity problem at home, where the lights keep flickering on and off instead of staying steady. Usually, the doctors will operate and put in a small machine that will ensure that the heart electrical system works correctly, but this woman, Madam X, might not survive such an operation. Many other medications that might help her had to be ruled out because of her kidney problems.
Her doctor, being a very smart cardiologist indeed, knew that there was a simple, non-invasive treatment that would improve her heart rhythms, relax the veins and arteries to take the pressure off of her heart, and would improve the muscle function of the heart. This medication is the same stuff that her body made when it was younger, so it won't cause any liver or kidney problems, and is relatively inexpensive. I'll even give you a really big clue-it will help improve her bladder control and incontinence problems. Give up?
Estradiol. The primary female hormone made by the ovaries before menopause.
Madame X uses an estradiol patch on her arm twice a week, and has not had cardiac arrhythmia problems since she started using it. At 82 years of age, this is not about hormone replacement therapy, but about finding the best treatment for her personal health problems. During the recent health crisis, the hospital removed her from all medications while it tried to figure out the source of her kidney problems-this is standard protocol with sound science to back it up. However, the loss of her estradiol patch nearly killed her as her blood pressure dropped and she developed heart arrythmias. After intervention from her cardiologist, her estradiol patch was replaced, and within hours her heart rhythm settled back down again. From a humane point of view, this was much less scary for an elderly, confused woman than a bunch of heart machines. From a cost point of view, this was thousands of dollars cheaper. She's feeling a lot better today. They will send her, with her estradiol patches, to a rehab facility in a day or two.
Want to read the research? Here's a list of selected research citations about cardiac arrhythmiasfrom the government research database, PubMed:
http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pubmed&IdsFromResult=20004189
Selected research about the effects of estradiol on the urinary tract is here:
http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pubmed&IdsFromResu
Dr. Elizabeth Lee Vliet, who specializes in women's health, has some similar stories in her books, Screaming To Be Heard, and It's My Ovaries, Stupid. Those stories, about young women with cardiac problems, deserve a separate post, though.