Hormone Therapy for Treatment of Menopause Symptoms May Be Safer Than Previously Reported

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by Lisa Larkin, MD, FACP, NCMP, IF

In September of this year, The Journal of the American Medical Association (JAMA) published results from the most recent study examining hormone therapy for women using data from the Women’s Health Initiative (WHI.) This latest study is important because it may impact the quality of life for the millions of women who seek treatment for menopause management, specifically hormone replacement therapy (HRT.)

The WHI followed more than 27,000 women who were given either some form of HT or a placebo for 5 – 7 years. The women were then tracked for more than18 years to examine the relationship between HT and diseases such as heart disease and cancer. However, prior to the release of the most recent study, much of the medical community believed misinterpreted results of the WHI that long-term HRT increased the likelihood of breast cancer.

However, the recent study demonstrated that women who received HRT had no increase in death rates due to any cause (including cancer or cardiovascular disease) than those who received placebo. These results are clearly in line with a position statement on HRT issued in June of this year by the North American Menopause Society (NAMS), which states that, “hormone therapy remains the most effective treatment for hot flashes and other troublesome menopause symptoms, regardless of a woman’s age.”

Many women experience bothersome hot flashes, night sweats, and pain during intercourse due to menopause, and hormone therapy has been proven as an effective treatment. However, as with all medication, HT may carry risks, depending on the patient’s age, the form (pill or cream,) and whether or not a woman is taking combined estrogen and progestogen (if she still has her uterus.) In the past, providers followed the script to use the “lowest dose for the shortest period of time,” but this new data suggests that providers and patients should work together to determine the ‘appropriate dose, duration, regimen, and route of administration’ to offer the most benefit with the least amount of risk.

As the NAMS statement points out, “Every woman is different—and you must make a decision about whether to use HT based on the severity of your symptoms, your personal and family health history, and your own beliefs about menopause treatments. Your healthcare provider will be able to help you with your decision.”

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