Hormone therapy safe in early menopause: researchers
LONDON (Reuters) - Women entering menopause should not worry about hormone replacement therapy -- despite a highly publicized study that put off many woman from the drugs, an international panel of experts said on Tuesday.
Researchers told a global menopause summit in Madrid that a 2002 study which discouraged many women from hormone replacement therapy (HRT) was flawed, as the subject group was relatively old and suffered from other conditions that all boosted risk.
Amos Pines, chairman of the International Menopause Society, said his team had reviewed dozens of published studies and found no increase in the risk of heart disease in women aged 50 to 59.
"The message is that each woman should discuss her general health, and risk factors such as family history...with her doctor, but generally healthy women entering the menopause should not have fears," Pines, of the Ichilov Medical Center in Tel Aviv, said.
HRT was popular until 2002 when a Women's Health Initiative study suggested it could raise the risk not only of breast and ovarian cancer, but also strokes and other serious conditions.
The findings spurred millions of women to abandon HRT and hit shares in makers of hormone therapies such as Wyeth.
But the international team of menopause experts -- which issued their consensus statement after reviewing the safety and effectiveness of HRT use in early menopause -- said HRT showed no increase in heart disease risk for women aged 50 to 59, and estrogen alone actually decreased risk for these women.
Certain types of HRT can slightly increase risk of breast cancer but it is minimal compared to other risks such as smoking or having a first child over the age of 30, they added.
"We are not suggesting that people should stay on treatment forever," David Sturdee, a researcher at Solihull Hospital in Britain who worked on the review, said in a telephone interview.
Not everyone is convinced, however.
Valerie Beral, an epidemiologist at the University of Oxford cautioned that the Pines-led review only looked at a fraction of the evidence, saying regulators recommend women only use HRT for short periods.
"They quote a small number of the very large studies that have been done," Beral said in telephone interview. "The review does not agree with regulatory bodies in the United Kingdom, U.S. or Europe who have reviewed the totality of the evidence."
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What breastcancer.org says about this article…
Hormone therapy safe in early menopause: researchers
The study reviewed here looked at the results from earlier studies on hormone replacement therapy (HRT), breast cancer risk, and other health risks. Based on their review of the data, the researchers concluded that HRT used to manage bothersome menopausal symptoms probably doesn't increase the risk of breast cancer or heart disease in women who use HRT early in menopause, before age 60.
It's important to know that these conclusions DON'T agree with the conclusions made by many other experts, who feel there is a lot of credible evidence showing that HRT, especially combination HRT (which contains both estrogen and progesterone), increases the risk of breast and ovarian cancer, as well as heart attack and stroke.
Some of the strongest evidence about the risks of HRT comes from a large study called the Women's Health Initiative (WHI). When WHI results were released in 2002, doctors and public health officials concluded that the risks of HRT were real and that HRT should be used with caution to manage menopausal symptoms. That conclusion still stands and Breastcancer.org agrees with it.
The side effects of menopause can dramatically reduce some women's quality of life. These women have to weigh the benefits of HRT against the risks. If you're having severe hot flashes or other menopausal side effects and are considering taking HRT, talk to your doctor about:
- how to minimize your breast cancer risk -- research shows that taking combination HRT for fewer than 3 years doesn't significantly increase breast cancer risk
- the pros and cons of different types of HRT -- estrogen-only HRT appears to increase breast cancer risk less than combination HRT
- a plan so you take HRT for the shortest time possible.
Together, you and your doctor can decide if HRT or another treatment to ease menopausal side effects might be right for you. If you decide to use HRT, try to make healthy lifestyle choices that can lower your breast cancer risk. During and after HRT, make sure to follow recommended breast cancer screening guidelines, including monthly breast self-exams, annual mammograms, and annual physical exams by your doctor.