Huron Regional Medical Center

HRT: Friend or Foe?

IN NEW DEVELOPMENTS IN MEDICINE

For decades millions of American women have been taking hormone replacement therapy (HRT) to relieve menopause symptoms. In addition, many more have continued to use HRT in hopes of reaping other health benefits, namely a lower risk of heart disease. However, new research released this summer suggests that HRT may not be the cure-all once thought. The findings came from the Women’s Health Initiative (WHI), a 15-year study of American women sponsored by the National Heart, Lung, and Blood Institute in collaboration with other units of the National Institutes of Health. The major focus of WHI is on ways to prevent heart disease, breast and colorectal cancer, and osteoporosis. Begun in 1991, the entire study is following more than 161,000 women. Within that number, many smaller studies are currently underway, including one on the affects of HRT. The main goal of the HRT study was to determine if hormone replacement after menopause actually helps prevent heart disease and hip fractures. Both of these are major health concerns for post-menopausal women, and both appear to be affected by the amount of estrogen in a woman’s body. A secondary goal was to see if the possible benefits outweighed the possible risks for breast cancer, endometrial cancer, and blood clots. Specifically, researchers investigated estrogen plus progestin therapy, with 16,608 women participating in the study. Now they’ve stopped the study after only five years. According to researchers, the estrogen/progestin HRT’s risks outweighed its benefits. Another study is currently underway to measure the affects of estrogen-only HRT. The estrogen/progestin therapy did not protect against heart attacks, though it does appear to reduce the risk of hip fractures in post-menopausal women. Other study results include the following:
  • 26 percent increase in breast cancer
  • 41 percent increase in strokes
  • 29 percent increase in heart attacks
  • doubled rates of blood clots in legs and lungs
  • 37 percent less colorectal cancer
  • 34 percent fewer hip fractures and 24 percent less total fractures.

What Does It Mean to Me?
Based on the findings from the estrogen/progestin study, the Women’s Health Initiative offers the following recommendations for estrogen plus progestin use:
  1. Therapy should not be continued or started to prevent heart disease. Instead, women should work with their physicians to find other prevention methods including lifestyle changes and cholesterol- and blood pressure-lowering medications.
  2. If concerned about osteoporosis, women should talk with their physicians and weigh the benefits against their personal risks for heart attack, stroke, blood clots, and cancer. Other medications are available to prevent bone loss.
  3. All women should practice good breast health, having regular mammograms and performing monthly self-exams.
  4. If you are simply taking HRT to reduce menopause symptoms, talk with your doctor. The Women’s Health Initiative has not yet studied short-term use of HRT.
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