Women and menopause: Fear overshadows facts about hormone therapy

Armen Hareyan's picture
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(NC)-Over the last two years millions of middle-aged and older women have been forced into an unnecessary state of alarm and bewilderment. The reason: the hormone therapy they had come to rely on to protect their bones, regulate their body temperature, mood, sleep and sex life was suddenly perceived as a danger to their health.

Holding their collective breath, these women watched as distressing news reports poured in on menopause hormone therapy citing a major clinical trial called the Women's Health Initiative (WHI). The study of 16,600 women revealed a popular estrogen-progestin combination, called Premarin and Provera, increases the rates of breast cancer and heart problems among its users.

The WHI study was cut short in 2002 because of a reported heightened risk of heart and other health problems. It concluded that these estrogen pills were an effective treatment for short-term relief of symptoms, but the risks where greater than the benefits for long-term treatment in the group of women studied.

Faced with mounting media reports warning them about the dangers of hormone therapy in general, countless women chose to dump their treatments and just suffer from their hot flashes and other symptoms without any drug therapy.

But buried under this media frenzy and fallout was something vital: the facts.

  • The fact that younger women were under represented in the study. The average age of women who participated was 63.5 with the majority falling between 60-79.

  • The fact that only oral delivery of hormone therapy was used in the research while other, newer modes like gel and patches were not included. These newer modes are known to have significantly different biological activities that may have altered the findings.

  • The fact that 97.5 per cent of patients had no events.

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  • The fact that the risk of each outcome was very small (0.1 per cent per year of use).

  • The fact that positive findings, such as a significant decrease in colon cancer rate was not highlighted.

As a result, experts on women's health such as the Society of Obstetricians and Gynaecologists of Canada (SOGC) reassured the public that HRT "remained a safe and effective option for the short-term treatment of moderate to severe menopausal symptoms." The SOGC no longer recommends, however, HRT in non-symptomatic women for the sole purpose of preventing heart disease or osteoporosis.

The good news for women who do suffer from severe symptoms came in the most recent findings from the second phase of the WHI study. It found that, after almost seven years of follow-up completed, estrogen alone has not increased the risk of breast cancer. The findings also show that estrogen alone does not appear to affect heart disease, a key question of the study.

The SOGC advises women to discuss the potential benefits and risks of hormones with their doctor, based on their personal health needs and risk factors, family and medical history.

The fact remains, for many women, the benefits of HRT actually outweigh the risks. Visit www.sogc.org for more information.

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- News Canada

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