If you're a woman who's put menopause behind her, takes oral estrogen and enjoys a daily drink or two, you may be getting more hormone than you bargained for. And with it, some potential health risks. That's what researchers concluded at Brigham and Women's Hospital in Boston, after looking at the effect alcoholic drinks have on blood levels of estradiol, the body's major form of estrogen.

In the two-day study of 24 women age 45 and older and at least one year past menopause, half were on oral estrogen replacement therapy (ERT); the other half took no hormones.

The first day, half the women were given a vodka cocktail; the other half got a placebo drink equal in calories, but with no alcohol. The next day, the groups switched drinks. (The amount of alcohol each woman got was calculated to be equivalent to a 130-pound woman drinking 3 1/2 glasses of wine.)

The results? For the women on ERT, estradiol levels rose significantly within 10 minutes of drinking the alcohol. By the time the alcohol reached its peak in the bloodstream at 50 minutes,estradiol levels more than tripled and remained somewhat elevated for the next five hours. In contrast, estradiol levels didn't increase in women not on ERT. Nor did they rise after the placebo drink in either group.

How alcohol increases estradiol is not clear, but the researchers speculate that alcohol may increase absorption of the hormone or decrease its breakdown.

Nearly 9 1/2 million American women use some form of estrogen replacement therapy after menopause to combat osteoporosis and heart disease. Yet excessive estrogen circulating in the blood may promote breast cancer and gallstones. This study suggests that women on estrogen who drink as little as 1 1/2 to 2 alcoholic drinks a day may be exposed to much higher estrogen levels than intended, and perhaps higher than is healthy.

What to do? Elizabeth Ginsburg, M.D., who headed the study, advises women who are on ERT and drinking daily to discuss the concern with their physicians. For the occasional social drinker, there is little, if any, reason to worry, she says.

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