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Early HRT Doesn't Reduce Heart Risk

Starting Hormone Therapy Around Menopause Offers No Decrease in Risk of Heart Disease

Is Today’s Hormone Therapy Safer?

Hormone therapy researcher JoAnn Manson, MD, who was a principal investigator for the WHI trial, tells WebMD that women taking hormone treatments today for menopausal symptoms may have a lower risk for treatment-related side effects than the women in the original trial.

That’s because the women who participated in the WHI intervention trial were taking much higher doses of estrogen than women typically take today and they took them for longer periods.

It is generally believed, but has not been proven in clinical studies, that the lower-dose hormone formulations widely used today are safer than the higher-dose formulations used a decade ago.

Many women now use a low-dose hormone patch, which has been shown to have a lower risk for blood clots.

“There is always a trade-off when you take any drug,” says Manson, who is chief of the division of preventive medicine at Boston’s Brigham and Women’s Hospital. “But it is important to point out that heart disease is not common in women around the time of menopause. Their risk is very low.”

Manson agrees with the current recommendation that women experiencing troubling menopausal symptoms take hormones in the lowest effective doses for the shortest duration possible.

She says most women should be able to discontinue treatment within two to four years.

North American Menopause Society Director Margery Gass, MD, says women with mild to moderate symptoms may find the relief they need with lifestyle modification and natural remedies.

For reducing hot flashes, she recommends getting plenty of exercise, dressing in layered clothing, using fans and air conditioning when needed, and avoiding spicy foods, alcohol or caffeine.

“These things do work for many women,” she says.


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