Deficits of Schmitt Study
1. Wrong Estrogen
- Premarin is not a human hormone
- Mostly Equilin
- low Estradiol- cardiovascular benefits are from E2
- No Estriol – E3 is protective
2. Wrong Progesterone
- Medroxyacetateprogesterone biock progesterone receptors and is not a human hormone. MPA reverses benefits of E2
3. Wrong route
Oral Estrogens increase inflammation. Estrogens should not be given orally. Oral Estrogens, by way of the first pass liver effects, increase the acute phase proteins including CRP and fibrinogen increasing the risk of thrombosis. Transdermal estrogens do not increase the risk of clot formation.
4. Wrong women
Most of the women were smokers were already established cardiovascular disease and were 8 or more years out since the onset of menopause.