BOSTON—Ten years ago, women were routinely encouraged to take hormones—estrogen alone or with progesterone—during the transition to menopause and beyond to protect against a host of chronic, aging-related health problems. Today, most women are hesitant to consider hormone therapy, even for short-term relief of hot flashes and other troublesome symptoms.
What changed? Findings from the federally funded Women’s Health Initiative (WHI) showed that taking estrogen, with or without progesterone, was more likely to raise risk for health problems, like blood clots in the legs or lungs, stroke, and gallbladder disease, than it was to protect against osteoporosis or colon cancer.
But the WHI left many questions unanswered, since the trial included mostly women who were well past menopause and evaluated only one type of estrogen (Premarin) and one estrogen-progestin combination (Prempro). So it’s still too early to close the book on hormone therapy, especially for short-term use or relief of menopause-related symptoms, according to the March 2011 issue of Harvard Women’s Health Watch.
The hormone saga has different messages for different women:
- For women who are a decade or more past menopause, hormone therapy probably isn’t a good option.
- For women troubled by vaginal dryness who no longer have hot flashes, vaginal estrogen is a reasonable option.
- For women in the transition to menopause who are bothered by hot flashes or other symptoms, hormone therapy shouldn’t be dismissed. Approach it as you might a pain reliever: take the smallest dose that does the job for the shortest time period.
Two randomized controlled studies now under way should provide more guidance on hormone therapy within the next two years.
Read the full-length article: “Hormone therapy: The next chapter”
Also in this issue:
- Terminal illness and saying goodbye
- Gallstone treatments
- Heart failure risk and chocolate
Harvard Women’s Health Watchis available from Harvard Health Publications (www.health.harvard.edu), the publishing division of Harvard Medical School, for $28 per year. Subscribe at www.health.harvard.edu/women or by calling 877-649-9457 (toll-free).
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