North American Menopause Society releases guidelines saying HRT beneficial for younger women

The North American Menopause Society on Thursday released a revised position statement that said the benefits of short-term hormone replacement therapy for treatment of menopausal women likely outweigh the risks for younger women, the Wall Street Journal reports (Parker-Pope, Wall Street Journal, 1/26).

Benefits of HRT include fewer hot flashes; better sleep; lower risk of diabetes and colon cancer; stronger bones; and, potentially, improved blood pressure, lowered risk of dementia and better "heart health." Women taking HRT have a higher risk of stroke, blood clots and gall bladder disease, as well as a possible higher risk of ovarian cancer and poor bladder control. Breast cancer risk is higher for women taking HRT containing estrogen and progestin, but estrogen-only HRT might lower the risk of breast cancer (Kaiser Daily Women's Health Policy Report, 1/12). The risks and benefits of HRT for prevention of cardiovascular disease, diabetes and osteoporosis still are unclear, according to the society's statement. The statement said research has shown a "trend" that women close to menopause who take HRT have had lower heart disease risk, but it added that women should not take the therapy to help protect their hearts. The statement also cited data from the Women's Health Initiative that found women who used estrogen and progestin were 21% less likely to develop diabetes, while women who took only estrogen were 12% less likely to develop the condition. In addition, a woman's risk of breast cancer increases after five years of taking HRT -- but that risk is low, about four to six additional cancer cases per 10,000 women per year -- according to the statement (Wall Street Journal, 1/26). Although the statement did not include specific guidelines of HRT use, it did suggest that women continue to take HRT for five years or fewer and that women take HRT only to relieve hot flashes, night sweats, and vaginal thinning or dryness, Reuters Health reports (Fox, Reuters Health, 1/25). The society said that more research into HRT use among women close to menopausal age is needed.

The statement "signals" that research regarding HRT "is still evolving and suggests that the verdict is still out" on the risks and benefits of the therapy, the Journal reports. Wulf Utian, executive director of the society, said experts are "mov[ing] away from the overly simplistic conclusions that originally came out of WHI" that HRT has the same risks for all women (Wall Street Journal, 1/26). Utian said HRT is "a lot safer than what the popular perception is out there in the real world," adding, "There is very little reason for old women to be taking these hormones" (Reuters Health, 1/25). JoAnn Manson, a Harvard University researcher and member of the panel that developed the statement, said, "I think these guidelines help to put the recent evidence and the new studies into perspective for women," adding, "There are many unanswered questions and many gaps in our understanding of the benefits and risks, so those research studies need to be supported" (Wall Street Journal, 1/26).

The position statement is available online. Note: You must have Adobe Acrobat to view this statement.