WEDNESDAY, Oct. 3 (HealthDay News) -- New research suggests that
hormone replacement therapy, used to relieve hot flashes and other
symptoms of menopause, might be safe for younger menopausal women
when taken in smaller doses for short periods of time.
Women have shied away from this type of therapy since the
landmark Women's Health Initiative study found elevated risks of
breast cancer, heart disease and other health problems among women
taking estrogen plus progestin, a synthetic form of progesterone.
That study was halted early because of the results, published in
2002.
But research scheduled for presentation Wednesday at the annual
meeting of the North American Menopause Society in Orlando, Fla.,
found that estrogen, either in oral form (Premarin) or as a patch
(Climara), plus a progesterone (Prometrium) did not harm the heart
either in terms of raised blood pressure or hardening of the
arteries.
Progesterone is added because estrogen alone can promote uterine
cancer.
In another part of the study, hormone replacement therapy did
help with mood and depression, researchers from the University of
Wisconsin School of Medicine and Public Health found. It did not
worsen memory, as the Women's Health Initiative had indicated, the
researchers said in a university news release.
The roughly 700 women participating in the study were age 53, on
average, and within three years of menopause -- the time when
periods stop. This was much younger than the average age of women
participating in the Women's Health Initiative, many of whom were
taking hormone therapy in the hope of staving off some of the
problems of old age, such as heart disease.
The new study, funded by the Phoenix-based Kronos Longevity
Research Institute, was too small to assess any effect on breast
cancer rates, one of the main concerns of women considering hormone
replacement therapy.
Some experts remain unconvinced by these latest findings. Among
them is Dr. Jay Brooks, chairman of hematology/oncology at Ochsner
Health System in Baton Rouge, La.
"I still say the bottom line is if you don't need to take [hormone replacement therapy], don't take it," Brooks said.
"The largest study to date of estrogen plus progestin [the Women's Health Initiative] showed an increased risk of heart disease and breast cancer and stroke, so if your symptoms are so severe you need to take it, understand there's a risk," he added. "And take as low a dose as possible for as short a time as possible."
Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill
Hospital in New York City, also expressed caution.
"We've gone back and forth on how safe hormones are and this is just one study," she said. "It only looks at early menopause and it's only looking at hardening of the arteries. It didn't look at breast cancer, which is also a very big concern."
Before she could wholeheartedly encourage patients to take
hormone replacement therapy in early menopause, Wu said she would
like to see more studies on breast cancer. "We may not catch breast
cancer in four years, though it may develop," she noted.
The new results reaffirm conclusions released in July by a
coalition of 15 leading medical groups, including the North
American Menopause Society, that hormone replacement therapy can be
useful and safe for many women suffering from symptoms of menopause
such as hot flashes and night sweats.
That statement said that hormone therapy is an acceptable choice
for relatively young (up to age 59 or within 10 years of menopause)
and healthy women who are bothered by moderate-to-severe menopausal
symptoms.
According to that statement, hormone replacement therapy
increases the risk for blood clots in the legs and lungs, although
this risk is rare in women 50 to 59 years old. Its use should be
decided on a case-by-case basis, the statement authors said.
Breast cancer risk appears to increase when hormone replacement
therapy is taken continuously for five years -- and possibly less.
The risk declines when hormone replacement therapy is stopped, the
coalition said.
The data and conclusions of research presented at medical
meetings should be considered preliminary until published in a
peer-reviewed medical journal.
More information
The
U.S. National Library of Medicinehas more on
hormone replacement therapy.