New hormone therapy studies revealed

March 4, 2008 7:24:34 PM PST
It's been nearly six years since a government trial on hormone replacement therapy was called off because of a higher risk of health problems, from heart attacks to breast cancer. Now, the results of a follow up study show that some of those risks have faded, but others have not.

This latest research followed the participants in the three years after the Women's Health Initiative was halted. Those who stopped taking the estrogen-progestin combination pill saw certain risks return to normal. But researchers found something quite different when they looked at cancer rates.

"What's alarming is the fact that all cancers were actually significantly increased in the women who had been on the hormones. So, this is after they stopped the hormones, their cancer risk continued," says Dr. Marsha Stefanick with the Stanford School of Medicine.

Stefanick is a professor of medicine at Stanford University and a lead investigator for the Women's Health Initiative. The large government trial focused on hormone replacement therapy that was called off in 2002 because of evidence of harm.

"Everybody asked then, 'how long will the risks continue? Will I continue the benefits?' So, that's what this data is about," says Dr. Stefanick.

This latest analysis appears in JAMA, the Journal of the American Medical Association. While the risk of heart problems appears to fade after three years, so do any real benefits linked with the pills.

"The cardiovascular risk disappeared, so the strokes were not increased, heart attacks, blood clots in the lungs, which was great news. Less good news is that the benefits to bones completely disappeared," says Dr. Stefanick.

Louise Stroschein takes estrogen alone to manage her symptoms of menopause. This latest research is focused on the combination of estrogen and progestin, but it still raises questions for her.

"I had to think about it today, 'how long have you been taking it?' and I realized it's been almost two years, and it's probably time for me to think about how should I stay on it. It's something I'm going to discuss with my doctor the next time I go in," says Stroschein.

"I actually think the FDA recommendations to go on as low a dose as you need to treat your symptoms and for shortest possible time should continue, and these data reinforces that," says Dr. Stefanick.

Researchers found a 24 percent increase in the risk of all cancers, but they also noted that amounts to just three extra cases per year for every 1,000 women on the pills. That's compared to those who never took them. They also saw 15 percent more deaths among those on the hormone pills, but that's a number that's not statistically significant, meaning it could be caused by chance.

"What we need to do is to continue to follow these women to see if in fact the deaths continue to increase in the group that had been on hormones, relative to the placebo group," says Dr. Stefanick.

The women who participated in the study will be followed until the year 2010. As for the risks associated with taking estrogen alone to manage the symptoms of menopause, that analysis will be completed next year.