WEDNESDAY, Sept. 10, 2003 (HealthDayNews) -- For women struggling with whether hormone replacement therapy is safe, studies are now simplifying the decision: In the short run they're fine, in the long term they're not.
That's the message a women's health expert will present to colleagues at a reproductive health conference in California Thursday.
More studies are yielding the same conclusions as last year's Women's Health Initiative (WHI) study, says Dr. Andrew M. Kaunitz, a co-principal investigator of the WHI.
That study, which tracked menopausal and post-menopausal women on combination estrogen and progestin therapy, found an increased risk of breast cancer, strokes and blood clots. The finding prompted investigators to halt the study in July 2002. Women who had been told to stay on hormones for life to control health problems ranging from menopausal symptoms to osteoporosis were left confused, scared and exasperated.
In the wake of the WHI, other studies and analyses of previous research have been published, Kaunitz says, and they're "all forming a cohesive picture." And it shows that combination hormone use long term by menopausal women does increase the risk of breast cancer and other problems, he says.
Kaunitz points to a study published last month in The Lancet, in which researchers who tracked more than 800,000 British women found those on hormone replacement therapy were at greater risk of developing breast cancer and of dying from it. The good news -- the risk seems to decline fairly quickly after going off the hormones.
But Kaunitz and other experts say there is still a role for hormone replacement therapy for the short-term relief of menopausal symptoms such as hot flashes or night sweats that can interfere with a woman's quality of life.
"Hormones remain the most effective treatment we have for women with bothersome hot flashes," says Kaunitz, a professor and assistant chairman of obstetrics and gynecology at the University of Florida Health Science Center.
"We are not talking about lifelong therapy," he adds.
Rather, he advises hormone replacement therapy at the lowest possible dose to manage menopausal symptoms short-term. Periodically, he suggests his patients taper off and then quit the medication to see if they still need it.
As long-term hormone replacement therapy has fallen out of favor, some attention has shifted to other ways of controlling symptoms.
For vaginal dryness, a common menopausal symptom, Kaunitz suggests either VagiFem, estrogen tablets inserted into the vagina twice weekly, or Estring, a removable ring that's left in place for three months.
For hot flashes, the medicinal herb black cohosh is often suggested. Researchers who presented a new study on Sept. 7 at the American Chemical Society's annual meeting say the herb may not work on estrogen receptors, as thought, but on serotonin receptors. The finding increases the likelihood the herb is safe, the researchers say.
To educate women about menopause and their options for symptom relief, several national organizations are hosting campaigns, including the U.S. Food and Drug Administration, the American Society for Reproductive Medicine and the National Women's Health Resource Center.
More information
For information on the menopause and hormones campaign, visit the National Women's Health Resource Center. Learn more about the Association for Reproductive Health Professionals.
