Panel Confirms Risks of Hormone Therapy
May. 30, 2012 - After looking at more than a decade's worth of studies on hormone therapy, an expert panel says that women shouldn't take estrogen or progestin to help prevent disease.
Instead, says the U.S. Preventive Services Task Force, these hormones should be used only to help relieve symptoms of menopause - and even then, at the lowest dose and for the shortest amount of time possible.
That's because the evidence now more clearly shows that taking menopause hormone therapy (MHT) raises the risk for several diseases, including stroke, gallbladder disease, dementia, blood clots, and urinary incontinence.
Although taking estrogen alone cuts the risk for breast cancer, the combo of estrogen and progestin raises the risk.
The task force looked at 51 published articles on nine research trials that met its criteria. The one benefit the panel confirmed was that MHT cut the risk for fractures.
MHT was once regularly prescribed to women to help prevent osteoporosis and cardiovascular disease. But the initial results of the Women's Health Initiative Study, published in 2002, found that the combo therapy of estrogen and progestin had harmful effects. Two years later, researchers found that the estrogen-only therapy also caused problems.
The task force also found that some of those earlier conclusions weren't as strong as originally laid out. Although the combo therapy was thought to significantly boost the risk for heart disease yet protect against colon cancer, later research has weakened those associations.
The task force will use these findings, published this week in the Annals of Internal Medicine, to revise its guidelines on MHT.
Heidi Nelson, M.D., at Oregon Health and Science University in Portland and who led the study analysis, says that it's important for women who need relief from menopausal symptoms to discuss the risks and benefits with their doctor.
Jill Rabin, M.D., at Long Island Jewish Medical Center in New Hyde Park, N.Y., says she tells her patients, is to "think local." Some women are helped by estrogen cream or estrogen vaginal rings, she says.
As you approach menopause, your body starts to vary the amount of estrogen and progesterone it makes. At some point, the amount of both hormones falls significantly. These changing hormone levels can cause hot flashes and other symptoms. After your last menstrual period, some symptoms of menopause might disappear, but others may continue.
To help relieve these symptoms, some women use hormones. This is called menopausal hormone therapy (MHT). MHT can be one of several different hormone combinations of hormones in a variety of forms and doses.
According to the American Medical Association, these are the main ways that MHT can be given:
- Estrogen pills
- Estrogen/progestin pills
- Estrogen and estrogen/progestin skin patches
- Estrogen cream
- Raloxifene, an estrogen-like medication
Talk with your health care provider about the benefits and risks of MHT.
Always talk with your health care provider to find out more information.