New Attempt at Solving HRT Controversy

(Ivanhoe Newswire) -- One week a medical group announces the benefits of hormone replacement therapy, and the next week another group of experts shun it. But they all seem to agree the need for a balanced discourse on both the pros and cons of the issue has never been greater.

“Before the first [Women’s Health Initiative] report was released in 2002, there was an overstatement of the benefits of hormone therapy in the medical community. Since that time, however, public opinion has probably shifted too far in the other direction -- overstating the risks of HT without acknowledging its benefits in relieving menopausal symptoms,” said Isaac Schiff, M.D., from Massachusetts General Hospital in Boston, speaking at The American College of Obstetricians and Gynecologists Annual Clinical Meeting in Philadelphia.

Dr. Schiff says experts and doctors need to formulate recommendations for women, especially now that new data was released in March by WHI on estrogen-only HT. This data comes just two years after their initial report on combined hormone therapy (estrogen and progestin).

Estrogen-only is solely given to women who have had hysterectomies because estrogen by itself can raise the risk of uterine cancer. WHI found that estrogen-only therapy showed no benefit in reducing heart disease and did not increase the risk of breast cancer in a six-year period. It did show a benefit in the prevention of osteoporosis. Like combination therapy, estrogen alone increased the risk for stroke in eight of 10,000 women.

Dr. Schiff reminds us that the 2002 studies on combined HT therapy showed increased risk for heart attacks, breast cancer, stroke, and blood clot.

But HT will not go away as it remains the most effective treatment for menopausal symptoms, especially for women who experience severe symptoms after hysterectomies, he says.

Now, ACOG recommends HT can still be used for treatment of hot flashes, but should be accompanied with medical consultations at least once a year, regular mammograms, and the smallest effective dose of HT for the shortest possible time.

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SOURCE: The American College of Obstetricians and Gynecologists Annual Clinical Meeting in Philadelphia, April 30-May 5, 2004