Back in April 2020, an article in the Journal of Women’s Health prompted me to think about the differences between men and women’s life and death responses to COVID-19. That article illustrated what we’ve heard in the news over, and over, and over again. Namely, that men tend to fare much worse than women if hospitalized with coronavirus (sars-cov-2) related diseases. Since then, we have come to know that, in this context, men are clearly the weaker sex. But even more data has emerged around the why, demonstrating that reproductive hormones are, in fact, an important part of women’s resistance to severe COVID-19 disease and can possibly even prevent death.
For most postmenopausal women, whether currently using menopausal hormone therapy or not, hormone therapy in early menopause (i.e., started in the first 10 years since their last menstrual period) is of significant benefit. Menopause specialists strive to determine the risk-benefit ratio for any woman before starting hormone therapy. It’s now clear that early menopausal women without absolute contraindications should seriously consider utilizing hormone therapy for disease prevention (i.e., heart attack and osteoporosis) and now to help prevent severe COVID-19 infections and even death.
Prevention of severe cases of COVID-19 may not be a good enough single reason to start hormone therapy, particularly as vaccinations are becoming more readily available. However, recent evidence documents that in women who start on hormone therapy for its basic, well-established benefits (treatment of hot flashes and night sweats, vaginal dryness and pain with sexual activity, prevention of osteoporosis etc. etc. etc.), may also benefit from the protection it provides against COVID-19 disease.
So, if you or someone you know wants a consultation to evaluate the benefit/risk ratio of postmenopausal hormone therapy, factoring in the potential benefits against severe COVID-19 infections, make an appointment to talk with us about all the options. All staff at IntimMedicine Specialists are fully vaccinated and we maintain careful CDC precautions, though we are also available for virtual visits. Menopausal hormone therapy may not only be good for you, it may save your life!
It’s been 18 years since the landmark Women’s Health Initiative (WHI) initial hormone therapy (HT) results. They gained worldwide attention by throwing HT “under the bus,” alleging the risks outweighed the benefits. I didn’t, and still don’t, endorse that conclusion, because estrogen therapy reduces the risks for heart disease, Alzheimer’s disease, and osteoporotic fractures among other benefits. Regardless of one’s point of view, almost 80% of women abruptly went off their HT.1 Here, I want to talk about the latest “potential” benefit of estrogen therapy… prevention of COVID-19 infection, and reduction in disease severity. Yes, you heard me, I can’t make this “stuff” up!2,3
The basics are these:
The severity of coronavirus infection appears to be greater in men than in women.
Estrogen reduces both influenza virus growth (replication) and the inflammation it causes.
These benefits of estrogen (replication and inflammation) are eliminated in animals when they lose ovarian function, like menopause, and are restored if those animals receive estrogen.
Pregnant women have high levels of reproductive hormones, including estrogen. 92% of pregnant Chinese women from Wuhan with COVID-19 had mild symptoms, and the other 8% all recovered from their disease. There were no deaths in pregnant women.
Taken together, estrogen seems to be protective against COVID-19, both the prevention of infection, and reduction in disease severity. So much so that clinicians and scientists from Stony Brook University Hospital in New York have launched a clinical trial using menopausal estrogen patches for the reduction of COVID-19 severity in both women and MEN!4,5 Yes, we are now giving menopausal estrogens to MEN. So, before you throw away your menopausal hormone therapy, think twice, it may be helpful in this COVID-19 pandemic.
Sprague BL, Trentham-Dietz A, Cronin KA. A sustained decline in postmenopausal hormone use: results from the National Health and Nutrition Examination Survey, 1999-2010. Obstet Gynecol. 2012;120(3):595‐603. doi:10.1097/AOG.0b013e318265df42
Suba Z. Prevention and therapy of COVID-19 via exogenous estrogen treatment for both male and female patients. J Pharm Pharm Sci. 2020;23(1):75‐85. doi:10.18433/jpps31069