For Hormone Replacement Therapy, Less Is More
June 7, 2001 -- There's good news for women undergoing menopause. New research shows that a lower dose of hormone replacement therapy is just as effective at reducing the symptoms of menopause, and it does so with fewer side effects than the higher dose currently used.
For many women, reaching menopause means suffering a host of uncomfortable symptoms, from hot flashes to concentration problems, because the body makes fewer female hormones. Worse, this decrease in female hormones places women at higher risk for developing heart problems and the bone disease osteoporosis, in which the bones become weaker and more susceptible to fracture.
Fortunately, hormone replacement therapy offers a solution for many of these ills, provided you can tolerate it. Some women cannot take hormone replacement therapy for fear it might worsen existing conditions, such as breast cancer, or because they cannot stand the vaginal bleeding that it sometimes causes. Now, two new studies in June's Fertility and Sterility indicate that taking a lower dose of hormones still has the beneficial effects with fewer side effects.
"For both women entering menopause who are symptomatic and for women who have been on [hormone replacement] long-term, we now have a lower dose that is effective," women's health expert JoAnn Pinkerton, MD, tells WebMD. "It works just as well at decreasing hot flashes and night sweats, ... yet it's safe and hopefully will have fewer side effects." An associate professor of obstetrics and gynecology and director of the MidLife Health Center at the University of Virginia Health System in Charlottesville, Va., Pinkerton co-authored one of the studies.
Co-author of the second study, David F. Archer, MD, tells WebMD that women taking the lower dose of hormone replacement therapy are "having less [vaginal] bleeding and spotting. ... That type of reduction in the occurrence of the bleeding episodes will enhance consumer willingness to comply with medication." Archer is a professor of obstetrics and gynecology and director of the Clinical Research Center at the Jones Institute of Reproductive Medicine at Eastern Virginia Medical School in Norfolk, Va.
Both studies were funded by the pharmaceutical company Wyeth-Ayerst Laboratories, the maker of the low-dose hormone therapy pill used in the studies. This new low-dose formulation contains about three-quarters the amount of the female hormones estrogen and progestin that is currently available in a Wyeth-Ayerst hormone replacement therapy product called Prempro.
Expert Nancy R. G. Church says, however, that "low dose" is a relative term. This new formulation is a lower dose than Wyeth-Ayerst's current Prempro formulation, but other manufacturers make hormone replacement therapies with slightly different versions of female hormones that are also quite low dose. These products also have been shown to reduce symptoms of menopause effectively with a low risk of side effects.