You probably know that a major clinical trial of hormone replacement therapy, or menopausal hormone therapy (HT), was halted in 2002. Researchers with the trial, a component of the Women’s Health Initiative, determined the drug had increased the risk of breast cancer, heart attacks and stroke in participants beyond the study’s safety margins. (See “A Closer Look.”)
And since then you’ve most likely heard or read numerous opinions about whether you should still take, or even consider, hormones for menopausal symptoms and to help fight osteoporosis—two areas where strong evidence suggests HT remains effective.
If you’re feeling overwhelmed by the HT debate, you’re not alone. To make an informed judgment about HT’s possible value to your well-being, talk to your doctor about the latest findings and how they affect you.
The study evaluated estrogen-plus-progestin therapy only. Results after 5.2 years showed it could be expected to cause seven more heart attacks, eight more strokes, 18 more blood clots and eight more cases of breast cancer per 10,000 women each year than in women not taking this form of HT.
As your body begins producing less and less estrogen during menopause, it may in fact be unwise to try replacing its heart-healthy benefits with HT. Where does this leave HT, you and your heart? While deciding, consider these points:
- Help reduce your heart-disease risk without HT by not smoking, keeping your blood pressure under 120/80 mm Hg, maintaining a healthy weight, eating plenty of fruits and vegetables and low-fat foods, getting regular aerobic exercise and keeping your cholesterol in check. Other heart-protective alternatives include aspirin therapy, statins that lower high cholesterol and antihypertensives to lower high blood pressure.
- Consider alternatives like Evista (raloxifene), a so-called SERM (selective estrogen receptor modulator). Designed to fight osteoporosis, it also lowers LDL cholesterol.
- Ask if you’d benefit from nonhormonal treatments for osteoporosis such as Fosamax, Actonel and Boniva, drugs that preserve bone mass and may reverse bone loss.
- Remember that only you and your doctor can fully evaluate all the different aspects of HT and menopause, and then decide what’s best for your health.
To read more on the study, visit www.nhlbi.nih.gov/whi.