Entries in hysterectomies (3)


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


Vaginal Mesh Product Under Scrutiny 

Jupiterimages/Thinkstock(WASHINGTON) - Surgical mesh treatments were developed over the past decade in part to avoid having to perform a hysterectomy on women with pelvic organ prolapse.

While surgical mesh has been used safely to treat hernias or urinary incontinence, the use of a mesh device, such as Prolift, which has several "arms" that spread out and attach at several places in the pelvis, is only a few years old.

However,  between 2008 and 2010, the FDA received 1,503 reports of injury, malfunction or death associated with the surgery. These reports represented a five-fold increase compared to a few years -- a spike that led the agency to issue warnings about these products last July.

In a review issued by FDA staff reviewers, they found that erosion occurred in 35 percent of all adverse events associated with mesh used in treating pelvic organ prolapse. Pain was reported 31 percent of the time; infection, 16 percent; and bleeding, 8 percent.

Now the FDA is considering pulling the product from the market, pending further safety data, and convened a two-day meeting of the Obstetrics and Gynecology Devices Panel Thursday to review the safety of using transvaginal mesh to treat pelvic organ prolapse.

But while erosion is a commonly reported problem, the high rate of adverse effects seen with the Prolift and similar products may have to do with the "arms" of the device, not the mesh itself, Dr. Emanuel Trabuco, a Mayo Clinic surgeon told ABC. He said that other complications may also be attributed to the several incisions that are necessary to insert the mesh and its arms.

The preliminary review presented at the hearing this week urged that surgical mesh devices for pelvic organ prolapse be reclassified and put through the standard safety regulations, but Trabuco said an all-out ban on these products should be avoided.

Echoing the comments made by the American Urogynecological Society, he said that more stringent use of the products and more safety data is necessary, but not an all-out ban.

Copyright 2011 ABC News Radio


Study: Stopping Estrogen Associated with Health Risks, Benefits

Siri Stafford/Photodisc/Thinkstock(SEATTLE) -- In 2004, the Women's Health Initiative Estrogen-Only Trial was stopped one year early because of an increased risk of stroke and no overall health benefit for the postmenopausal women who had hysterectomies taking the medication. A new long-term study continued following many of the women after they stopped the estrogen and finds that their age was associated with certain ongoing health risks and benefits long after taking the last pill.   

Dr. Andrea La Croix, from Fred Hutchinson Cancer Research Center in Seattle, and co-authors compared the on-going health risks and benefits in women who took the estrogen for an average of six years then stopping and those who did not. Follow up for most of the women lasted almost 11 years. "For heart disease overall we found no difference either during the intervention at the end of the intervention or at the end of this longer- term follow up period no difference between the estrogen group and the group  of women who took a placebo pill," explained La Croix.

The study appears in this week's JAMA, Journal of the American Medical Association and researchers say those results differ by age group. According to La Croix, "women in their 50s taking estrogen had 12 fewer heart attacks per 10 thousand women over a year's time and the women in their 70s had 16 extra heart attacks, so the effect of estrogen on heart disease differed significantly by age."

"For breast cancer a woman's age had no effect on their risk, the risk of breast cancer was reduced regardless of age. Hip fracture rates also reduced while on the medication but that changed after women stopped," according to La Croix.  Rates of hip fracture in the treated group started to rise and move toward the rate in the placebo group so that by the end of the 10.7 years of follow up the rates were about equivalent.

Researchers say this new information can now be used by women to help them and their physicians make better informed decisions on whether to  start this medication and just how long they should take it. 

Copyright 2011 ABC News Radio

ABC News Radio