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Evidence Mounts Against Synthetic Hormone Replacement Therapy

Posted by Jane Akre
Tuesday, March 04, 2008 10:58 PM EST
Category: Major Medical, Protecting Your Family
Tags: FDA and Prescription Drugs, Women's Health, Breast Cancer, Heart Attack, Stroke, Hormone Therapy

More evidence that synthetic hormone replacement may have more risk than benefit.

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For menopausal women who stop hormone replacement therapy (HRT) an increased risk of breast cancer continues. 

The findings give more weight to the conclusion that the risk of hormone replacement therapy outweigh the benefits, at least for progestin and estrogen.

The findings appear in the March 5th issue of the Journal of the American Medical Association (JAMA) and is based on data from the Women’s Health Initiative (WHI).

That trial that had to be stopped in 2002, earlier than anticipated, when postmenopausal women on HRT specifically estrogen plus progestin, had a higher risk of cardiovascular disease, stroke, blood clots and breast cancer.  

That's when the medical establishment made an about-face and thousands of women and their doctors reevaluated synthetic hormone replacement. 

This study follows-up with those same women three years after the end of the hormone replacement study and follows 15,730  who originally participated in WHI.   

Women who took HRT in the form of Prempro have some good news.  Women who were on HRT for about five years prior to 2002 and stopped taking the drug had a lower risk for stroke, heart attack and blood clots. But the benefits to the bone disappeared too. 

But what apparently doesn’t go away, at least not right away, is the risk of cancers specifically breast cancer. 

Deaths from any cause were 15 percent higher in women from the Prempro group than among the placebo group. The authors conclude that the risks of combined HRT exceed the benefits.

The results only apply to women who take combination hormone therapy.  And Dr. James Liu who was the principal investigator for the WHI in Cincinnati until 2001, says the risk of breast cancer increases with age independent of taking HRT. Eventually he believes that the effects on HRT on breast cancer risk will also subside.

But the news is not all bad. The risks are actually very small. For 1,000 women there will be three extra cases of cancer and among 1,000 women there will be one case of breast cancer. For some suffering through menopause, hormone replacement therapy may be worth the risk.

Dr. JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital told Time Magazine,  "So for women who are having distressing menopausal symptoms, who are not sleeping, they are going to get quality of life benefits and it's important for them to understand what the absolute risks are."

Dr. Susan Lark has been writing about women’s health issues for decades. Among her suggestions reduce meat, wheat and dairy consumption while increasing flax seed or oil and soy to minimize the imbalance that comes after menopause. Her web site offers books and products as well as information on the subject of HRT.

Still to be determined is whether estrogen alone will yield the same results. That WHI data is forthcoming. 

Dr. Jeffrey Dach a natural medicine MD, says The Women’s Health Initiative study published in JAMA July 2002 showed that Provera, a chemically altered form of progesterone causes increased risk of cancer and heart disease, while the natural, human bioidentical progesterone does not. 

Today’s HRT offers women a dosage about half of years prior and women are directed to say on it for about two to three years.  And many women find relief with progesterone creams often made with bio-idential yams that are applied to the skin.

Dr. Larry Norton, director of breast cancer programs at Memorial Sloan-Kettering Cancer Center, summarizes the results to ABC News: "If you are taking HRT [hormone replacement therapy], try to stop. If you are not taking HRT, don't start."

Just last week the Archives of Internal Medicine reported that women who took HRT for about five years had abnormal mammograms which were tough to read largely because the breast tissue was denser. That also led to more invasive breast biopsies.

The Women’s Health Initiative is the most ambitious project of its kind. It began in 1991 to uncover the role hormones play among menopausal women in causing or helping the symptoms of heart disease, osteoporosis and cancers. 

It will continue to follow almost 162,000 post menopausal women until 2010. #

 


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