Reassurances Offered to Women Fearful of Gaining Weight on Hormone Replacement Therapy
Jan. 7, 2000 (Los Angeles) -- Women reluctant to use hormone replacement
therapy (HRT) due to fears that they'll gain weight can put their minds at
ease, say Boston researchers. They found that menopausal women on HRT weigh
less and have less body fat than those not taking hormone replacement. The
study appears in the current issue of the journal Menopause.
The women on HRT also had a lower body mass index (BMI), a measure of how
close someone is to their ideal weight. "This study adds to the body of
literature that suggests the women who are on HRT should not be concerned about
weight gain," lead author Raja Sayegh, MD, tells WebMD.
Sayegh and his team analyzed the body fat composition of 169 women in
natural or surgical menopause for at least one year. The patients were all seen
between 1990 and 1995 at Massachusetts General Hospital and its two affiliated
health centers. The investigators measured body fat using a handheld device.
They also obtained information on the patients' lifestyles, diet, and smoking
and drinking habits through telephone interviews and by reviewing records.
Women taking HRT had 4.8% less body fat than women who did not take the
hormones. When age differences and other confounding factors were accounted for
through statistical analysis, the use of HRT emerged as the only factor
significantly associated with lower fat and BMI.
Sayegh, who is assistant professor of obstetrics and gynecology at Boston
University School of Medicine, warns that the data are far from conclusive, in
part because the women studied were mostly white, affluent, and healthy.
Senior researcher David Chelmow, MD, concurs, saying that there may have
been "all sorts of biases" involved. For example, clinicians may
hesitate to prescribe HRT to extremely overweight women. "Because of the
study's limitations, you have to look at it in terms of the other literature
that's out there," Chelmow, associate professor in the division of general
obstetrics and gynecology at Tufts Medical School, tells WebMD. "However,
[these data suggest] that if a woman is concerned about weight gain, she can be
reassured on that issue."
Women thinking of going on HRT should discuss their options with their
physicians and weigh all the issues carefully, both researchers say. "Our
central questions involve heart disease and bone loss as opposed to fears of
breast cancer," says Chelmow.
HRT lowers the risk of heart attacks and bone fractures, but it slightly
increases the risk of breast cancer, so women with a personal or family history
of breast cancer may want to consider alternatives. Sayegh points out that
there are also "nuisance effects" to consider, such as bleeding. A
woman's personal view of menopause may also affect her desire for HRT.
"Does she view it as a medical condition or just another stage in her
life?" asks Chelmow.
"This is a complex issue," he concludes. "The findings of this
study may be a small factor, but if someone is concerned about weight gain,
they may help tip the balance in favor of HRT."
- According to a recent study, women taking HRT weigh less and have less body
fat than other women.
- One problem with the study is that the women were mostly white, affluent,
and healthy, which could cause the results to be biased.
- Women should consult with a physician to help them carefully assess all of