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Women Confused About HRT

Many questions still surround hormone replacement therapy

THURSDAY, Dec. 12, 2002 (HealthDayNews) -- A new national poll reveals that women are confused about hormone replacement therapy, perhaps not surprising in the wake of several recent studies on the subject.

"A lot of women still have a lot of questions, so doctors need to know that women will be beating a path to their door for answers. And doctors need to be prepared to discuss the implications of the research, giving consideration to a woman's own risk factors and preferences," says Ashley Coffield, a senior fellow with the Partnership for Prevention.

The Partnership for Prevention, a nonprofit health policy research organization based in Washington, D.C., commissioned the poll and released it today.

Hormone replacement therapy (HRT) is typically prescribed to prevent symptoms of menopause such as hot flashes, night sweats and vaginal dryness. However, some physicians have also prescribed it for perceived disease-prevention effects.

In July, however, researchers stopped a part of the Women's Health Initiative (WHI) study that was employing the commonly used combination of estrogen and progestin because it showed an increased risk of heart disease, breast cancer, blood clots and strokes.

Since the WHI bombshell, the public has been deluged with yet more studies concerning HRT. Among other things, it appears that the type of progestin used and the dosing intervals may have an effect on health risks.

No wonder the new survey found that just as many women felt confused about HRT (24 percent) as felt better informed (27 percent).

The poll, which surveyed 1,003 women aged 55 to 70, found that nearly one third of the women (32 percent) still believe HRT can help protect against heart disease, breast cancer and stroke.

Dr. Steven R. Goldstein, a professor of obstetrics and gynecology at New York University School of Medicine, says two of three women who called him in the wake of the WHI announcement weren't even taking HRT.

"I told them what I told them in July, which is the same thing I've been saying for the last several years -- that the study shows that using HRT to prevent heart disease doesn't work," Goldstein says. "The reason to use HRT has been and continues to be relief of transitional symptoms and quality of life issues, none of which was addressed with WHI."

"The 51-year-old woman who is absolutely beside herself with hot flashes, can't sleep, can't put two sentences together, her life has totally derailed -- it is absolutely ridiculous to deprive that woman who needs short-term relief from taking HRT because of data from the WHI, which was not designed for that woman," Goldstein adds.

One-quarter of the women surveyed said the WHI findings either caused them to stop taking HRT, consider stopping it or explore alternative treatments.

The poll also found that the majority of postmenopausal women were still concerned about heart disease (79 percent) and osteoporosis (67 percent).

To which Coffield responds: "There are things that women can do to prevent osteoporosis and heart disease -- stop smoking, exercise more and eat healthy foods and perhaps talk with a doctor about other medications other than combined HRT."

"Our message is that combined HRT should not be taken to prevent heart disease and that physicians should urge caution about using it solely for osteoporosis," she says.

What To Do

For more on hormone replacement therapy, visit the National Library of Medicine or the National Heart, Lung, and Blood Institute.

SOURCES: Steven R. Goldstein, M.D., professor, obstetrics and gynecology, New York University School of Medicine, New York City; Ashley Coffield, MPH, senior fellow, Partnership for Prevention, Washington, D.C.; Dec. 12, 2002, poll, Partnership for Prevention
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