In U.S., No Comeback Seen for Hormone Therapy

Experts say risks of long-term use still outweigh possible benefits

By Dennis Thompson
HealthDay Reporter

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SUNDAY, Aug. 9 (HealthDay News) -- Hormone replacement therapy once seemed like a wonderful means to help women age gracefully. By dosing menopausal women with estrogen and progesterone as their bodies began to produce decreased amounts of those hormones, doctors believed they could help fend off heart disease, osteoporosis and cancer.

But those beliefs collapsed in 2002, when researchers pulled the plug three years early on the Women's Health Initiative, a large-scale, federally funded study of hormone replacement therapy (HRT). They had found that the therapy produced an increased risk of breast cancer, heart attack, stroke and blood clots. HRT has been pretty much taboo ever since.

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Or has it?

Several studies released in the past year have revealed ways in which HRT might still be beneficial. Under certain conditions and with the right timing, they found, some women could be helped by the therapy.

Despite these findings, experts with the American Cancer Society and the American Heart Association say there's scant chance there will be any revision on the position on HRT in the United States anytime in the near future.

"In an effort to decrease hot flashes, it's hard to tell someone to take the breast cancer risk and the heart and stroke risk shown in other studies," said Dr. Vincent Bufalino, a spokesman for the American Heart Association and president and chief executive of Midwest Heart Specialists, in Naperville, Ill. "If you can put up with the menopausal symptoms, you're better off doing that than taking the risks related to hormone replacement therapy."

Research that has shown the more positive side of HRT has included:

• A report on a Mayo Clinic study that found a lower rate of colorectal cancer among older women taking HRT.
• A report by American Cancer Society epidemiologists that found that women could use an estrogen-progesterone combination for less than two years with no increased risk of breast cancer. It also found that cancer risk increased dramatically after three or more years of hormone therapy and that increased risk disappeared two years after stopping HRT.
• A Danish study that found an increased risk of heart attack in women 51 to 54 years old who took hormone replacement therapy, especially those who'd taken it for a long time. But it found no correlation between hormone therapy and elevated heart attack risk in older women.
• A Canadian study that found women who have a genetic predisposition to breast cancer actually reduced their breast cancer risk after taking HRT.

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