Could Hormone Supplements for Menopause Return?

Why Hormone Replacement Therapy May Be Safer Than You Think

Why Hormone Replacement Therapy May Be Safer Than You Think

Taking hormone therapy to treat menopausal symptoms like hot flashes does not increase a woman's risk of early death, according to a long-term follow-up of trials that were stopped early due to health concerns.

That research was halted early when more breast cancer, heart attacks and strokes occurred in women on combined pills than in dummy pill users.

"It is a bit surprising that given the many risks of hormone therapy identified during the treatment phase, the net effect on all-cause mortality was neutral", says Manson, who leads one of the WHI's multiple study sites.

"Hormones may be appropriate for some women when used short-term to relieve hot flashes and other bothersome menopause symptoms", said Dr Manson, who was also part of the original research. During the five to seven years of treatment, the death rates in the women aged 50-59 tended to be approximately 30 percent lower among women who received hormone therapy when compared to women of the same age who received placebo.

"All women should be assessed at menopause for symptoms; bone health, sexual health and their overall medical condition and then be individualized and we have both hormonal and non-hormonal options for women", said Thacker.

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By the end of the 18-year study, the death rates from any cause among the women receiving some form of hormone therapy were similar to that of women who took the placebo.

The new study, led by investigators at the U.S. Brigham and Women's Hospital (BWH), examined the long-term rates of death from all-causes, and the rates of death from specific causes, including cardiovascular disease, cancer and other major illnesses over a follow-up of 18 years among 27,347 women from the two WHI hormone therapy trials.

The findings were published Tuesday in the US journal JAMA.

The 2002 report found that hormone replacement therapy increased women's risk of breast cancer and stroke, Lichtenfeld said.

"This study does not mean that a woman can nonchalantly start hormone therapy and stay on it for the rest of her life", he said.

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Overall, nearly 7,500 women died. After that, many doctors became reluctant to prescribe hormone therapy for menopause symptoms.

Cancer-related deaths linked to combination estrogen/progesterone therapy appeared to be a wash, as the treatment increased risk of breast cancer but decreased the risk of uterine cancer, Manson said.

However, among women who initiated hormone therapy in their 60s and 70s, no effect on death rate was observed.

"Women with existing health problems, for instance asthma, need to be followed more thoroughly through the menopausal transition and be provided with advice on medications that take the changing hormone levels better into account - ideally with a personalised approach", Triebner added.

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