Entries in HRT (5)


Menopause Hormone Therapy Benefits Hit in Government Report

iStockphoto/Thinkstock(WASHINGTON) -- Hormone replacement therapy may provide relief from the hot flashes, night sweats and other oppressive symptoms of menopause, but when it comes to preventing chronic health problems, a panel of experts for the federal government said HRT isn’t helpful and may be harmful.

The U.S. Preventive Services Task Force on Tuesday recommended against the use of HRT for the prevention of chronic conditions, such as coronary heart disease, breast cancer and fractures, for postmenopausal women.  The panel classified the recommendation as “grade D,” meaning there is “moderate to high certainty” that the risks of HRT outweigh any long-term health benefits that women might gain.

The panel noted that the recommendations don’t apply to women taking HRT to relieve hot flashes, vaginal dryness and other postmenopausal symptoms.  Women’s health specialists say increasing evidence indicates that reasonable use of the therapy to fight those symptoms can have big benefits for women’s quality of life.

“For newly menopausal women who have these symptoms and are in generally good health, the benefits of treatment are likely to outweigh the risks,” said Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital in Boston.

The USPSTF’s recommendations are the latest chapter in the often-confusing story of hormone replacement therapy, which was once considered a possible tool for preventing chronic maladies such as coronary heart disease and fractures.  But the Women’s Health Initiative, a 10-year study of nearly 70,000 women, found that women who took both estrogen and progestin actually had an increased risk of blood clots, heart attacks and strokes, as well as a higher risk of developing breast cancer.  The trial was halted three years early in 2002.

The USPSTF cited evidence gleaned from the Women’s Health Initiative in its latest recommendations, saying that the use of estrogen-only HRT or a combination of estrogen and progestin was linked with an increased risk of stroke, gallbladder disease, urinary incontinence and blood clots.

For women taking estrogen-only HRT, the panel found modest benefits in the way of reducing bone fractures and smaller reductions in the risk of developing or dying from invasive breast cancer.  But the panel said those small positives were outweighed by the more major risks of the therapy.

Copyright 2012 ABC News Radio


Documentary Reveals the Good, Bad, Ugly of Menopause

iStockphoto/Thinkstock(NEW YORK) -- "When I think of menopause, I think of hate, pure clean hate," one woman said in the new documentary Hot Flash Havoc.

"I told my wife if she goes through menopause again, we're getting a divorce," a husband said.

Nevertheless, "you're very lucky to reach menopause," another woman said. "If you don't reach it, you have some troubles."

Hot Flash Havoc, a film of "menopausal proportions," is a documentary meant to examine menopausal symptoms, reveal the history and society's view on menopause and even question the results from an ongoing National Institutes of Health initiative, which, in 2002, discouraged women from taking estrogen plus progesterone to treat symptoms of menopause.

For some women, menopause symptoms are much more than the occasional hot flash. Depression, low libido, night sweats and panic attacks are only a few of the many indications that storm through the body of a menopausal woman.

The controversial documentary will be released to the public March 30.

The beginning of the documentary creates a playful dialogue on the experiences and expectations of menopause and menstruation.

For one woman, the roundabout way in which she was told about her feminine health left her confused for decades.

"Your Aunt Tilly is going to visit you once a month, and she's going to hang around for about 30 years," the interviewee described how her menstrual cycle was explained. "When Aunt Tilly dies, you'll know about it cause she won't come around no more. Who the hell is Aunt Tilly?"

The majority of the film documents the benefits of estrogen replacement therapy, commonly taken to curb hot flashes and other menopausal symptoms. It particularly criticizes a NIH Women's Health Initiative study, which, in 2002, found that women taking estrogen were at higher risk of certain cancers and heart disease. Researchers halted the clinical trial altogether in 2002 because of the noted increased risk.

Filmmakers and menopause experts interviewed in the documentary argue that the 2002 study results were misrepresented, and led millions of menopausal women to unnecessarily stop taking hormones that otherwise curbed debilitating symptoms sometimes associated with menopause.

And research released last week in the Lancet reignited this debate when a study found that estrogen-only hormone replacement therapy might lower the risk of breast cancer for some postmenopausal women. While the findings were specific to women who have had a hysterectomy, have no increased risk of breast cancer and no increased risk of strokes and blood clots, advocates of hormone therapy welcomed the results.

"Menopause has been this secret filled with shame, anxiety and confusion for centuries," said Heidi Houston, executive producer of the film. "The movie is intended to give information so every woman can make informed decisions about treating menopause and allow women to become health care advocates for themselves."

Prior to the 2002 study, some preliminary research found that the menopausal hormone therapy actually helped to decrease the risk of heart disease, but the preliminary data found the treatment did not decrease risk and put women at increased risk of some invasive breast cancers and stroke. Prior to the study results, hormones were one of the most prescribed drugs in the country.

But the use of estrogen dropped by 71 percent from 2001 to 2009, according to the North American Menopause Society.

"Women with a uterus who are currently taking estrogen plus progestin should have a serious talk with their doctor to see if they should continue it," Dr. Jacques Rossouw, acting director of the WHI at the time, explained in 2002. "If they are taking this hormone combination for short-term relief of symptoms, it may be reasonable to continue since the benefits are likely to outweigh the risks. Longer term use or use for disease prevention must be re-evaluated given the multiple adverse effects noted in WHI."

Dr. Marcia Stefanick, a researcher on the WHI study, told ABC News that the questions the initiative set out to answer were not specifically on menopause, but about the health risks and benefits of menopausal hormones for older women, "for whom they were being prescribed to prevent common diseases of aging women (i.e. heart disease, osteoporosis and dementia)."

"As it turns out, menopausal hormone therapy did not reduce heart disease in older women and it increased strokes," Stefanick said.

The treatment indeed helps to curb hot flashes. It also helps prevent vaginal dryness and preventive bone loss, she said. While temporary use of the treatment likely has mild risks, women deserve to know them, Stefanick said. And menopausal hormone therapy taken for several years has shown an even greater risk of the adverse health conditions.

But critics of the study said the patient population was skewed. While the study included more than 16,000 women ages 50 to 79, the average age of women in the study was 63. On average, women begin menopause around 51 years of age, when most women will experience the most severe of their symptoms.

"There was no question that there were more risks for women over 60 years of age," Dr. June La Valleur, director of the Mature Women's Center at University of Minnesota Medical Center, wrote in an email. "Women need to have options and to say that no one should use estrogen or estrogen/progestin therapy for menopausal symptoms is absurd."

Dr. Alan Altman, president of the International Society for the Study of Women's Sexual Health and a menopausal expert interviewed on the documentary, told ABC News, "Women were instilled with fear that wasn't necessary and they need to understand that they can let that fear go and make a good, educated decision about menopausal hormone treatment."

New WHI data came out in 2008 and found that three years after women stopped taking the hormone therapy, increased risk of heart disease diminished. But women were still at a slightly increased risk of stroke, blood clots and cancer.

As for Houston, the executive producer said the motivation for the documentary came from her own challenges in dealing with menopause and not knowing all her options.

"Menopause is a natural change that is going to happen to everyone," Houston said. "I believe we have the right to have all the information available to us so we women can make our own choices. Whatever a woman's choice is, whether she wants to take hormones or not, it doesn't matter, as long as she has the options so she can decide on how to have the best quality of life."

Copyright 2012 ABC News Radio


Study Finds Estrogen Replacement Lowers Risk of Breast Cancer for Some Women

iStockphoto/Thinkstock(NEW YORK) -- Millions of women who seek relief from hot flashes, night sweats and other postmenopausal symptoms -- but fear the risks of hormone replacement therapy -- have some reassurance from new research on estrogen-only HRT.

A new study suggests that estrogen-only HRT may lower the risk of breast cancer for some postmenopausal women. However, the findings apply to a particular subset of those women -- those who have had a hysterectomy, have no increased risk of breast cancer and no increased risk of strokes and blood clots.

The research came as a follow-up to the Women's Health Initiative, a 10-year study of more than 10,000 women taking HRT. The trial was halted in 2004 amid concerns that the treatments increased women's risk of stroke and breast cancer. The end of the trial was followed by a drop in the number of women taking estrogen for their postmenopausal symptoms. A study from the North American Menopause Society found that the use of estrogen dropped by 71 percent from 2001 to 2009.

The concerns that stopped the trial were mostly linked to combined HRT -- a combination of estrogen and progestin, which doctors still say increases a woman's risk of breast cancer. Garnet Anderson, the lead author of the study, said fear over those risks tainted the reputation of estrogen-only HRT, even though researchers had already observed that it seemed to reduce the risk of breast cancer.

"These new data suggest that women don't have to be afraid of taking estrogen-only HRT," she said.

Researchers studied more than 7,500 postmenopausal women who had undergone a hysterectomy and had taken estrogen-only HRT as a part of the Women's Health Initiative. The women, aged 50 to 79, took estrogen for six years and then stopped when the trial was halted.

But researchers continued to monitor the women for the next five years and found that the women who took estrogen were 23 percent less likely to develop breast cancer than those who took a placebo. Of the women taking estrogen-only HRT who did develop breast cancer, the study found that they were less likely to die from the disease. Six women taking estrogen died of the disease, compared with 16 in the group taking a placebo.

Dr. Jacques Rossouw, chief of the Women's Health Initiative at the National Heart, Lung and Blood Institute, said the study suggests that the length of time a woman takes estrogen may play a role in her risk of developing breast cancer.

"If they use it [estrogen] for short term and then stop after 6 years or so, they are not at increased risk of breast cancer," he said. He cautioned, however, that the use of estrogen for longer periods may increase the risk.

Women who have not had a hysterectomy should not take estrogen-only HRT, since estrogen increases the risk of uterine cancer.

The findings, published day in the medical journal The Lancet, give a little more clarity for women who want relief from their postmenopausal symptoms but feel confused by all the conflicting information on whether or not HRT is safe. Dr. Janet Pregler, director of the Iris Cantor-UCLA Women's Health Center, said her patients are often frustrated by the conflicting reports on HRT. But she said she has prescribed estrogen alone for several years to her postmenopausal patients who have had hysterectomies.

"There's no question that hormones remain the best treatment for hot flashes and night sweats," Pregler said. "The risk of doing that for a few years around menopause is really very low, depending on other health risks you have."

The study found several caveats to the effectiveness of estrogen-only HRT. The reduced risk of breast cancer applied only to women who were not already at risk for the disease. As a result, Anderson said patients should not take estrogen with the goal of reducing breast cancer risk.

Also, HRT is still associated with an increased risk of stroke, and doctors say that women who are at increased risk of stroke and blood clots should still avoid taking any HRT.

Copyright 2012 ABC News Radio


Study: Anti-Depressants Relieve Hot Flashes

Photo Courtesy - Getty Images(PHILADELPHIA) -- For women passing through menopause, hot flashes can become the bane of their lives. Hormone replacement is one therapy, but it comes with significant risks. Now a new drug made for a different ailment could be of some help. 

HRT for menopausal women is hugely controversial, as it can increase a woman's chances of breast cancer, heart attack, and stroke.  Now a study in the journal of the American Medical Association examines an alternative treatment. 

Other studies have shown that some anti-depressants can alleviate hot flashes. This study focused on one of them, as 205 women with hot flashes were given either escitalopram or a placebo for eight weeks. Women taking the drug reported an average reduction of 4.6 hot flashes per day. Those on placebo had an average reduction of 3.2 hot flashes per day. That's a little over one less hot flash a day. Overall, the study found the drug reduced hot flashes by 47 percent compared to a 33 percent reduction in the placebo group.  And women taking escitalopram reported their hot flashes were less severe. 

The authors say escitalopram is a non-hormonal alternative to help women control the symptoms of menopause. 

Some of this study's authors have consulted for, and received funding from forest laboratories, which sells escitalopram under the brand name lexapro.

Copyright 2011 ABC News Radio


Study: Estrogen-Only Therapy May Reduce Breast Cancer Risk

Photo Courtesy - Getty Images(SAN ANTONIO) -- For years, doctors have warned women that taking hormone replacement therapy, or HRT, may be linked to an increased risk of breast cancer.  Now, a new study suggesting that a particular form of HRT may actually lower the risk of breast cancer in some women is likely to re-ignite the controversy surrounding this link.

The study, presented at the annual San Antonio Breast Cancer Symposium, uses previously collected data to suggest that menopausal women with no strong family history of breast cancer who are on estrogen replacement therapy may be at a 30-40 percent lower risk of developing breast cancer.

Lead researcher Dr. Joseph Ragaz, medical oncologist and clinical professor at the School of Population and Public Health at The University of British Columbia in Vancouver, Canada, acknowledged the study results fly in the face of conventional thinking about findings contradicting a widely held belief about HRT.

"Our analysis suggests that, contrary to previous thinking, there is substantial value in bringing HRT with estrogen alone to [treatment] guidelines," said Ragaz in a press release.  "The data show that for selected women it is not only safe, but potentially beneficial for breast cancer, as well as for many other aspects of women's health."

Ragaz and his colleagues re-analyzed data from hormone replacement therapy trials of the Women's Health Initiative, a national health study aimed at developing strategies for preventing heart disease, breast cancer, colorectal cancer and bone fractures in postmenopausal women.

Copyright 2010 ABC News Radio

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