HRT Helps Quality of Life

Poll: HRT Helps Quality of Life

From the WebMD Archives

Oct. 2, 2002 --"Hormones do enhance quality of life," says Wulf Utian, MD, PhD, executive director of The North American Menopause Society (NAMS), which commissioned the survey.

"In fact, hormones help women maintain a level of quality of life that's the same as women who do not have symptoms," Utian tells WebMD. He is also a reproductive endocrinologist and professor emeritus at Case Western Reserve University School of Medicine in Cleveland.

The survey results were presented at the 13th annual meeting of the NAMS held this week in Chicago.

It's more grist for the mill as women sort through the many studies released lately -- pro and con HRT. The Gallup survey found that women are well aware and concerned about the risks found in other studies.

Gallup's telephone survey involved 600 women across the country between ages 50 and 64, all postmenopausal for at least one year. Of those women, 37% were taking HRT. Some had been taking it for more than 15 years, some for just 6 months.

To measure women's quality of life, the surveyors asked women about their overall health, emotional well-being, sexual function and interest, loss of sleep, and their feelings about their work. The questions also assessed women's physical symptoms such as hot flashes and vaginal dryness.

Women taking HRT had better quality of life in all areas, with 35% moderately satisfied and 51% reporting being "very satisfied." Hot flashes emerged as the most important factor, says Utian. "Those without hot flashes reported significantly better quality of life whether they took HRT or not."

The survey also captured women's attention to the HRT issue.

While Gallup was still making calls and compiling data, the early results of the Women's Health Initiative (WHI) study were announced this past July. The news that one arm of the WHI study was being terminated affected women's perceptions of HRT, Gallup researchers found.

Women were asked if they were aware of the news and if it had any effect on their quality of life.

"An overwhelming portion of women had heard about the WHI study," Utian says. Also, "for many women taking HRT, their sense of optimism and well-being dropped. It's the anxiety [that kind of news] creates. You find that something you are taking may be bad for you."


However, women who had taken HRT for one or two years actually had improved well-being scores, likely reflecting the reassurance short-term users got from WHI findings, he says.

Women who had taken HRT longer than two years reported greater numbers of symptoms such as night sweats, likely because they were concerned and focusing more than normal on symptoms, says Utian.

"Women should look carefully at what the studies are and what they are not," he says. "Then, take a deep breath. One study's findings are not necessary applicable to the typical perimenopausal woman -- the woman trying to decide whether to take HRT or not. In most studies, the women were older and had more severe symptoms than most women."

"It's important to note, the WHI study did not look at [how HRT prevented the] symptoms [of menopause]," says Margaret Gass, MD, professor of obstetrics and gynecology at the University of Cincinnati College of Medicine and director of the University Hospital Menopause and Osteoporosis Center in Cincinnati.

Gass has been a principal investigator of several clinical research studies that have focused on menopause and postmenopausal women, including the WHI study.

"WHI was looking mainly at HRT as a preventive therapy [for heart disease and osteoporosis]," she tells WebMD.

Hormones are on the market and FDA-approved to treat menopausal symptoms such as hot flashes whether they happen during the day or night, says Gass. "Those symptoms have secondary effects like sleep disruption, which means you're not feeling good the next day. So there are some ramifications to hot flashes; it's not just the few seconds you have hot flashes."

Keep in mind that menopausal symptoms are transient, she says. "It's a phase, and that's all. And it's variable from woman to woman; 20% do not have hot flashes. We do not know why. Some have symptoms one year, some have them for up to five years. Some have symptoms occasionally. But typically, they do become milder and less frequent."

Women need to weigh the risks and benefits, says Gass. "You might also consider practical measures to relieve symptoms, like trying to keep your environment cool since heat will trigger hot flashes. Wear natural fibers, hot spicy foods." Exercise and paced breathing also help.


Utian is also a proponent of "good, healthy living" to get past the uncomfortable symptoms of menopause. "I've never believed that HRT was the only answer," he tells WebMD. "There are many was to deal with [them], like diet, exercise, no smoking."

There are a lot of reasons not to take HRT, he says. "Certain women who should not take it, or should think twice -- like women who have a history of blood clots, active liver disease, strong family history of cardiovascular disease, or breast or colon cancer."