Wall Street Journal examines debate over alternative HRT to treat menopausal symptoms

The Wall Street Journal on Saturday examined the debate over the risks and efficacy of alternatives to hormone replacement therapy for treatment of menopausal symptoms. Summaries appear below.

• "A Safer Prescription for Menopause?": Women take a "litany of drug regimens" -- including antidepressants, osteoporosis drugs, sleep aids and prescription anti-inflammatories -- to handle symptoms of menopause that previously were treated with traditional HRT. According to the Journal, physicians are beginning to worry whether the "shift away from hormones [has] made women safer or ... just subjected them to a whole new set of drug risks." After results from the Women's Health Initiative study showed that women using estrogen and progestin appeared to have a higher risk of breast cancer and heart disease, use of HRT has dropped. According to IMS Health, sales of menopause hormones declined by 33% from 2001 to an estimated $1.9 billion in 2005, and sales of estrogen-progestin combination therapy decreased by 8% in the first half of this year from the year-earlier period. Sales of estrogen therapies dropped by 4%. Shari Lusskin, director of reproductive psychiatry at New York University Medical Center, said, "People are saying, 'If it's hormones we won't take it, but I'll take anything else you'll hand me.'" She added, "But there's no medical treatment that has only benefits and no risks. Patients have to be educated consumers and think carefully about what drugs they're going to take" (Parker-Pope [1], Wall Street Journal, 10/21).
  
  
• "Treatments: The Debate on Compounded Hormones": A debate is "raging" about what to call hormones that are custom mixed by pharmacists and whether they are any safer than commercial hormone preparations or prescription drug alternatives. The treatments are called "bio-identical hormones" and have the same molecular composition as hormones produced by a woman's body. They often are promoted as "natural" hormones that do not have the same risks as hormones sold by drug companies, the Journal reports. FDA has said that women should assume that all hormone treatments have the same risks and benefits, though commercial hormone products have that warning, while compounded treatments do not. Critics say that the terms "bio-identical" and "natural" are misleading to women who think their bodies will respond differently to the treatments than to commercial hormone drugs, the Journal reports. There is no is published evidence that compounded hormones are safer or more beneficial that tradition HRT, according to the Journal. "The argument is not against the use of compounded hormones," Wulf Utian, executive director of the North American Menopause Society, said, adding, "The argument is that women aren't being informed" (Parker-Pope [2], Wall Street Journal, 10/21).