By: Beth Walsh for Uterus1A new analysis of data from a landmark study released in 2002 has redefined the best use of hormone therapy. The original study results, based on more than 16,000 women ages 50 to 79 using estrogen-progestin or a placebo for an average of five years, indicated that increased risk of heart attack, stroke and breast cancer outweighed any benefits.
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The average age of menopause in the United States is 51 years old, and the menopause transition lasts about four years. There is no way to predict when an individual woman will enter menopause: age can range from the thirties or forties up to the sixties.
Generally, women can expect to experience menopause around the same age as their mother was when she went through it.
The most common symptoms of menopause include abnormal vaginal bleeding, hot flashes, problems sleeping, vaginal dryness, mood changes and a decrease in libido. Symptoms are the result of changes in hormone levels. When a woman goes through menopause, her ovaries stop producing estrogen and progestin.
Treatments for menopause are tailored to the individual’s unique situation. | |
Many questioned the results because the majority of the women were well past the age most start taking hormones – and there was no accounting for the time period since menopause. However, the number of women undergoing hormone therapy has dramatically declined.
Before the 2002 study was published, hormone therapy was considered as almost a fountain of youth. Researchers and practicing clinicians widely believed that hormone therapy prevented heart disease, breast cancer and osteoporosis, among other conditions.
The new look at the data from the Women’s Health Initiative revealed that hormone therapy does not increase the risk of heart attack for women in their fifties, but does increase risk for older women. Published in the Journal of the American Medical Association, the new study found that women in their sixties and seventies who still had hot flashes and night sweats were at increased risk for heart attacks, even if they were not undergoing hormone therapy. Those taking hormone therapy were at a higher risk.
Other recent studies have shown that hormone therapy provides no overall benefit for disease prevention. And, a combination therapy of estrogen and progestin together may raise the risks of heart attack, stroke and breast cancer, while estrogen alone may raise the likelihood of a stroke.
This re-evaluation of the Women’s Health Initiative data indicates that if women in their fifties want to take hormone therapy to relieve menopause symptoms, they should be sure their blood pressure is controlled and they should have regular mammograms. But, if women start taking hormones in their fifties, they cannot safely continue the treatment into their sixties and seventies. There appears to be a window of opportunity in the fifties to treat symptoms of menopause without increasing a woman’s risk of other serious medical problems. Even then, women should use hormones only to relieve symptoms and only at the lowest effective dose for the shortest possible time.
