HRT scare questioned

Apr 8 2007

According to the latest research hormone replacement therapy (HRT) may not be quite as dangerous as was first implied by a major American study in 2002.

The Women's Health Initiative (WHI) resulted in a worldwide health scare five years ago when the risks of life-threatening conditions were first revealed.

The study results caused millions of women to stop using the therapy and doctors and health officials to issue warnings about the longterm use of HRT.

The latest analysis of combined data from two parts of the study data has however found no increased risk of heart attack for women in their fifties who were taking HRT and even a slight reduction in the risk, and for women between 50 and 60 taking HRT the overall risk of death from any cause was reduced.

For women in their sixties and seventies who are still struggling to cope with the symptoms of the menopause such as hot flushes and night sweats, there does however appear to be an increased risk of heart attacks and strokes even if they are not taking HRT and that the risk is slightly increased for those taking the medication.

The new findings suggest that HRT use in women aged 50 to under 60, when most women experience the menopause, does not increase the risk of heart disease.

Dr. Jacques Rossouw, a researcher for the National Heart, Lung and Blood Institute who directed the WHI says women older than 60 should not take it.

The researchers however describe their analysis as exploratory rather than definitive.

Many experts on women's health have called the findings a "dramatic U-turn" and an affront to science.

The new analysis attempts to answer persistent questions about hormone therapy that arose from the Women's Health Initiative which included 27,347 women ages 50 to 79 who were randomly assigned to receive hormones or not.

One study involved women who had not had hysterectomies who took Prempro, a drug made by Wyeth that combines estrogen and progestins.

The other involved women who had had a hysterectomy and who took estrogen alone which can cause cancer of the uterine lining and should not be used by women with a uterus.

The main objective of the studies was to establish whether hormone therapy could prevent heart attacks which many doctors expected; instead, it was found that Prempro increased the risk of heart attacks, strokes and breast cancer, and estrogen alone increased stroke risk.

At the time the studies came in for harsh criticism from gynecologists in particular, who pointed out that most of the women in the study were long past menopause and questioned whether the findings applied to women, in their 50s, who had just entered menopause.

The investigators combined data from both studies and examined health risks in the 50s, 60s and 70s in order to address those issues.

They concluded in their new analysis that while women in their 50s taking Prempro or estrogen alone had a slightly increased risk of strokes and breast cancer, there was no increase in their risk of heart attacks.