Mayo Clinic Study Re-Evaluates Dangers of Hormone Therapy for Hot Flashes
It’s common wisdom among women of a certain age that hot flashes and other symptoms caused by menopause are not pleasant. And yet, for over a decade, many women suffering from menopausal symptoms have veered away from taking hormone therapy after a large-scale study put forth by the Women’s Health Initiative (WHI) raised concerns about the safety of post-menopausal women who had taken it.
According to an article in HealthDay News:
The Women’s Health Initiative found that hormone therapy using estrogen and progestin increased a woman’s risk of heart attack, stroke, blood clots and breast cancer, compared with placebo. Estrogen alone increased risk of blood clots and stroke, but made no difference in heart attack risk and had an uncertain effect on breast cancer.
“We saw a significant decline in the use of hormone replacement therapy as a result of that study,” [Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society] said, with doctors now limiting use of hormone therapy solely to women with severe menopausal symptoms.
The new study, introduced by the Mayo Clinic in Rochester, Minnesota, suggests otherwise. The study combined the data from 43 randomized, controlled trials on hormone therapy. The trials included more than 52,000 women, aged 50 or older. It found that neither estrogen nor estrogen combined with progesterone (two of the common therapies available) increased a woman’s risk of death from heart attack, stroke, or cancer.
“This is the latest update of the current evidence,” said lead author Dr. Khalid Benkhadra, a research fellow at the Mayo Clinic in Rochester, Minn. “I can say there’s no risk of dying from any reason because a woman is taking hormone replacement therapy.”
The results, Benkhadra said, should allay concerns of some women with debilitating menopausal symptoms who have feared taking hormones.
While the study has not been refuted, some experts are not yet willing to give women the green light to take hormone therapy:
…Heart and cancer doctors who reviewed the new findings said that hormone therapy should still be used sparingly on those most in need, until further research proves otherwise.
“This study may provide some comfort that it shouldn’t shorten your life, but it doesn’t change the concern that the bad effects of hormone therapy are going to be an issue,” said [Lichtenfeld].
Lichtenfeld added that the review’s results are preliminary, and haven’t been subjected to the rigorous peer review necessary for a study to be published in a medical journal.
“No one should change treatment until the data is examined more closely,” he said.
Others in the medical community suggest the issue is more complex:
“Hormone therapy has a complex balance of benefits and risks,” said [Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital, a professor at Harvard Medical School, and one of the WHI’s principal investigators], who also serves as a spokeswoman for the American Heart Association. “The risk of many health outcomes decreased, even while other health outcomes were increased.”
For example, hormone therapy reduced women’s risk of fractures, colorectal cancer and diabetes in the WHI, even though it increased risk of other potentially fatal conditions, Manson said.
“Because it’s such a very complex profile of benefits and risks, all-cause mortality doesn’t capture the full picture. For a woman who dies from a stroke, it won’t matter to her that there was a neutral effect on all-cause mortality,” she said.
“We really recommend personalizing the hormone therapy decision-making process to the underlying risk factors of each woman,” Manson said, noting that younger women in their 50s and closer to the start of menopause tend to have fewer negative consequences from the therapy. “There’s no one-size-fits-all answer.”
Any decision to change treatment for menopausal symptoms should be discussed with your physician. If you have questions about hormone therapy medications, please visit any Owens Healthcare location and speak with one of our pharmacists.