A swarm of recent findings about menopausal hormone therapy (HT) has provided both new insights and contradictory information on its medical value. But has anything been resolved one way or the other?
Well…yes and no. The Women’s Health Initiative, after little more than five years, abruptly halted its study of postmenopausal women taking a combination of estrogen and progesterone, noting that the risks of taking these hormones outweighed any benefits. Among its findings:
- The risk of developing breast cancer was higher in women taking estrogen plus progestin.
- The risk of suffering heart attacks, strokes, or blood clots in the lungs and legs was higher in women taking estrogen plus progestin.
- The risk of hip and other fractures or colorectal cancer was lower in women taking estrogen plus progestin.
- There were no differences in the risk of endometrial cancer (cancer of the lining of the uterus) or in the number of deaths between the group of women taking estrogen plus progestin and those who did not take hormones.
HT may protect against colon cancer. And it is possible that HT fights Alzheimer’s disease and even halts cataracts. However, the American Heart Association no longer recommends HT for heart protection alone. That’s because studies show HT won’t prevent a second heart attack in women who already have cardiovascular disease, or CVD. And even for women who don’t have CVD, HT may pose a risk.
Moreover, HT increases the risk of blood clots in the chest and legs, which could cause stroke. Used alone, estrogen raises endometrial cancer risk, and HT may increase a woman’s risk for breast cancer. With all these concerns, it’s little wonder that many women have quit using HT, health experts say.
As further results come in, a better medical understanding of HT will emerge. Until researchers clear up the HT issue one way or the other, use these guidelines in collaboration with your doctor’s advice to decide if it’s right for you:
- Don’t overreact. Some physicians still suggest that HT’s ability to help prevent osteoporosis and treat symptoms of menopause may outweigh cancer risks for some women.
- Proceed carefully. If used for more than five years, HT may cause a small increase in risk for breast, endometrial, and ovarian cancers. Just how much of an increase—and what happens past five years—are issues that scientists want to clarify.
- Consider alternatives. Instead of HT, many women opt for increased calcium and a nonhormonal drug that fights osteoporosis, like Fosamax, Actonel or Boniva. Tamoxifen and raloxifene can also preserve bone density. For heart health, your doctor may prescribe cholesterol-lowering medications and aspirin to provide cardiac protection without cancer worries.
- Think. HT remains a highly personal issue that only you and your doctor can decide. Your medical history, risk factors and lifestyle choices must be weighed. HT has helped thousands of women feel better, but only you and your doctor can decide if it will help you, too.