Breast Cysts Preclude Estrogen Use

Q:  Could you tell me how important it is for a post-menopausal woman with coronary disease (I had bypass surgery) to take Premarin to help the heart and blood vessels? I am having trouble with breast cysts that have to be drained occasionally, and my surgeon thinks Premarin is the cause and I should discontinue it. I will be looking for an answer to help me weigh the problem.

A:  The latest studies in the past four years have clearly shown that estrogen does not decrease the risk of future heart attacks in women who already have coronary heart disease, especially in the first few years of taking it. The benefits for the heart seem to start about 5 years after being on estrogen - which is the same time the risk for breast cancer starts increasing.

Since your breast cysts are probably due to your use of estrogen, I agree with your surgeon that you should try stopping estrogen and see what happens.

There are many other approaches you can take to protect your heart, including following a low fat diet, using cholesterol-lowering medication, doing regular exercise and practicing stress management.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.