When women were introduced to Hormone Replacement Therapy (HRT or
HT), a light beamed at the end of the menopausal tunnel and everything
great that went with it.
But when a 2002 study by the Women’s Health Initiative (WHI) reported that HT increased a woman’s chance of stroke, breast cancer, heart attack, and blood clots in the lungs and legs, a serious anxiety was sparked regarding the harsh reality of hot flashes, brittle hair and sagging jowls.
The report stated that when hormones were combined — namely estrogen and progestin, and taken together, the risks far outweighed the benefits of trying to look “feminine forever.”
Just this month, however, Dr. JoAnn Manson, a lead investigator of the WHI study since its birth back in 1993, discussed the organization’s latest findings with NPR’s Nancy Shute.
Manson, also a professor of medicine at Harvard’s School of Public Health, says that this summary pieces together over 100 articles on the monitoring of “27,347 postmenopausal women while they were in the two HRT randomized trials and in the years after,” which were published in the Journal of the American Medical Association (JAMA).
She notes that these latest results are broken down by a woman’s age and starting point of menopause, adding that “This is really what women and their clinicians have needed in order to interpret the findings and provide individualized care.”
The key is, that hormone therapies or HT for a 50-year-old women will not produce the same effects on a woman who is much older. Manson states, “The recommendation is, don’t use hormones for chronic disease prevention, but do consider whether younger women [could use them] for treatment of moderate to severe symptoms of menopause.”
Further, while it appears that estrogen alone reduced the risk of breast cancer, taking it with progestin increased breast cancer risk.
To this, Manson says, “We don’t really have a clear understanding of the mechanisms for a finding of lower breast cancer risk for conjugated estrogen alone. It really needs to be looked at more carefully.”
HT should not only be adjusted according to a woman’s age, but also regulated when considering factors such as whether some have had hysterectomies, etc. Read:
“The study found that for women with no family history of breast cancer, estrogen seemed to offer some additional protection against breast cancer,” as well as “the results of the new study may be reassuring to some women, namely those taking estrogen for shorter durations, say a few years, following a hysterectomy.”
Manson cautions that estrogen-only results cannot be generalized to a population at large. The story here is that there are different kinds of hormone therapies and different types of women.
For example, estrogen and progestin –when taken together for long periods of time may be harmful, but women who still have a uterus need to take progestin when they’re on hormones in order to protect against uterine cancer. So, for them, the estrogen-only therapy is not an option.
Dr. Hugh Taylor, Professor of Obstetrics and Gynecology at Yale University, believes that one possible solution might be to find a better balance of estrogen and progestin. As in, using progestin just part of the month. Or local doses of progestin just to the uterus — where some need it.
Dr. Janet Pregler, Director, Women’s Health Center at UCLA, advises that ”Hormone therapy should be used in the smallest possible dose for the shortest period of time necessary to control symptoms.”
The bottom line, is do your research ladies. Ask questions and be your own advocate–especially when it comes to something that could be have harmful results and where the jury is still out.
But when a 2002 study by the Women’s Health Initiative (WHI) reported that HT increased a woman’s chance of stroke, breast cancer, heart attack, and blood clots in the lungs and legs, a serious anxiety was sparked regarding the harsh reality of hot flashes, brittle hair and sagging jowls.
The report stated that when hormones were combined — namely estrogen and progestin, and taken together, the risks far outweighed the benefits of trying to look “feminine forever.”
Just this month, however, Dr. JoAnn Manson, a lead investigator of the WHI study since its birth back in 1993, discussed the organization’s latest findings with NPR’s Nancy Shute.
Manson, also a professor of medicine at Harvard’s School of Public Health, says that this summary pieces together over 100 articles on the monitoring of “27,347 postmenopausal women while they were in the two HRT randomized trials and in the years after,” which were published in the Journal of the American Medical Association (JAMA).
She notes that these latest results are broken down by a woman’s age and starting point of menopause, adding that “This is really what women and their clinicians have needed in order to interpret the findings and provide individualized care.”
The key is, that hormone therapies or HT for a 50-year-old women will not produce the same effects on a woman who is much older. Manson states, “The recommendation is, don’t use hormones for chronic disease prevention, but do consider whether younger women [could use them] for treatment of moderate to severe symptoms of menopause.”
Further, while it appears that estrogen alone reduced the risk of breast cancer, taking it with progestin increased breast cancer risk.
To this, Manson says, “We don’t really have a clear understanding of the mechanisms for a finding of lower breast cancer risk for conjugated estrogen alone. It really needs to be looked at more carefully.”
HT should not only be adjusted according to a woman’s age, but also regulated when considering factors such as whether some have had hysterectomies, etc. Read:
“The study found that for women with no family history of breast cancer, estrogen seemed to offer some additional protection against breast cancer,” as well as “the results of the new study may be reassuring to some women, namely those taking estrogen for shorter durations, say a few years, following a hysterectomy.”
Manson cautions that estrogen-only results cannot be generalized to a population at large. The story here is that there are different kinds of hormone therapies and different types of women.
For example, estrogen and progestin –when taken together for long periods of time may be harmful, but women who still have a uterus need to take progestin when they’re on hormones in order to protect against uterine cancer. So, for them, the estrogen-only therapy is not an option.
Dr. Hugh Taylor, Professor of Obstetrics and Gynecology at Yale University, believes that one possible solution might be to find a better balance of estrogen and progestin. As in, using progestin just part of the month. Or local doses of progestin just to the uterus — where some need it.
Dr. Janet Pregler, Director, Women’s Health Center at UCLA, advises that ”Hormone therapy should be used in the smallest possible dose for the shortest period of time necessary to control symptoms.”
The bottom line, is do your research ladies. Ask questions and be your own advocate–especially when it comes to something that could be have harmful results and where the jury is still out.
0 comments:
Post a Comment