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Reassurances Offered to Women Fearful of Gaining Weight on Hormone Replacement Therapy

WebMD Health News

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."

Vital Information:

  • 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 their options.

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