Posted on 02/06/2002 5:28:20 AM PST by Flipper4
A study published today is raising new doubts about hormone- replacement therapy for post-menopausal women.
The study found that most women taking estrogen experienced a decline in such quality-of-life measures as energy and the ability to do everyday activities. Only those women who were experiencing menopausal hot flashes, which are relieved by estrogen, reported an improved quality of life.
The new research "should challenge the widely held belief that hormone therapy helps women remain more youthful, active or vibrant," said an editorial that accompanied a report of the study in the Journal of the American Medical Association.
Other recent studies found estrogen does not protect against heart attacks or Alzheimer's disease.
"Estrogen has been disappointing, and the more we find out, the more disappointing it gets," said Dr. Marie Veldman of Advocate Christ Hospital's Women's Health Center in Oak Lawn.
Natural estrogen levels in women decline at menopause. As a result, 50 percent to 80 percent of women suffer from problems including hot flashes, night sweats, vaginal dryness and insomnia. Studies have shown that estrogen therapy relieves these menopausal symptoms, but there has been controversy over other potential benefits of the widely prescribed treatment. An estimated 38 percent of U.S. women between 50 and 74 are on hormone replacement.
The new research involved 2,763 postmenopausal women randomly assigned to receive either Prempro--a pill containing estrogen and progestin--or a placebo. The women were followed for three years and surveyed on four quality-of-life measures. Wyeth-Ayerst, which makes Prempro, funded the study. Among women who had hot flashes at the start of the study, those given hormones had less depression and overall better mental health than those on the placebo. Among women who didn't have hot flashes, hormone users reported less energy and less capacity for everyday activities, including household tasks and sexual relations.
"The most likely explanation is that when you don't have any [menopausal] symptoms, it's hard to make you feel better," said the study's lead author, Dr. Mark Hlatky of Stanford University's medical school.
The study has limitations. The average age of participants was 67, and all had heart disease, so the findings don't necessarily apply to younger women with no heart disease. And the results might not apply to women who take estrogen without progestin.
Hormone therapy improves cholesterol levels. Early studies showed it also reduced the risk of heart disease. But these studies might have been flawed because participants who took hormones exercised more and were thinner and less likely to have diabetes than women in the studies who didn't take hormones.
A recent study compared heart patients who took hormones with women who took a placebo. The result: Hormone therapy did not prevent further heart attacks or death. Similarly, other recent studies have contradicted earlier research showing that estrogen reduces the risk of Alzheimer's disease.
Hormone therapy increases bone density, which can reduce the risk of fractures from osteoporosis. But there are other ways to do that, too, including exercise, calcium and vitamin D supplements, and taking drugs such as Evista and Fosamax. Long-term estrogen use increases the risk of endometrial cancer, but that risk could be eliminated by combining estrogen with progestin. Using either estrogen alone or both hormones for more than five years might increase the risk of breast cancer. Estrogen also increases the risk of blood clots and gallstones.
Recent studies might cause a slow shift away from hormone therapy, said Amy Allina of the National Women's Health Network. "More and more questions are being raised about the volume of hormone-replacement therapy, and what the risks are," Allina said.
But some experts advise the 11 million hormone users not to throw away their pills. "We have not seen the total answer," said Dr. David Archer, an obstetrician- gynecologist at Eastern Virginia Medical School. "I believe there are benefits that can accrue from estrogen."
Dee Obirek, 59, of Oak Lawn isn't giving up on estrogen. The hormone has dramatically relieved her hot flashes, insomnia, anxiety and depression. She hopes it will protect her from heart disease and osteoporosis.
"I've made my decision, and I'm sticking with it," she said.
Depression is common in middle-aged women. We are busier even than when we have babies - getting kids through high school or settled in college; taking care of elderly parents or relatives; supporting our husbands through various midlife crises, career changes, etc. We have a lot of things to worry about, as do our husbands, and that leads to a lot of anxiety in some women. Taking estrogen isn't going to solve these problems either.
That paragraph above is what should be the key point in this article. Shoddy reporting makes people more confused.
I get Vitamin E and a good multiple at the health food store. They also have a good progesterone cream that you dab on an arm, or your chest or whatever you are comfortable with. I used to really suffer with the symptoms mentioned, but I feel great now! I am 67, and had to try several different things since my 50's.
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I also pray while walking those 3 miles. So, if you have prayer requests, let me know and I'll add you to the list. If I have to increase my prayer walk, I will!
As a student of medicine I've often found it annoying how some in the profession often wants to use one "blanket" therapy for everyone with a certain problem/disease/disorder. Medicine needs to be assessed on a case by case basis. Giving HRT to every woman post-menopaus is not only lazy its irresponsible.
And anyone who says God has no sense of humor, does not know God :-)
JaneG, what kind of doctor should I see about hormone tests? A doctor here has anti-aging clinic and weekly radio show touting hormone replacement -- not just estrogen -- for staying young and vibrant. I believe he charges more than I can pay, but like his ideas....any suggestions?
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