Nonoral HRT May Be Safer
Women in European Study Had Lower Cardiovascular Risks, Blood Pressure
Oct. 10, 2002 -- Women wishing to stay on hormone replacement therapy (HRT) who are concerned about the potential health risks may want to consider abandoning oral treatment in favor of other delivery routes, new research suggests.
Investigators conducting a small European study in which HRT was given in the form of estrogen skin patches and vaginally administered natural progesterone say these methods may be free of the cardiovascular risks that have recently been associated with oral hormone therapy. As an added benefit, postmenopausal women who were on the regimen for one year lost weight, lowered their blood pressure, and had less vaginal bleeding.
But a menopause expert contacted by WebMD says even though some women are better off taking nonoral HRT, there is little evidence that all women would fare better on nonoral regimens.
"One size definitely does not fit all when it comes to hormone replacement therapy," North American Menopause Society (NAMS) executive director Wulf Utian, MD, PhD, tells WebMD. "When a women talks to her healthcare provider about HRT, the discussion should include not only whether she should take it, but what regimen she should be on."
In light of the recent controversy surrounding HRT, a NAMS panel recently issued a report clarifying its position on the treatment. The panel concluded that relief from the symptoms of menopause should be the primary reason for being on HRT and that women should take the treatment for the shortest time possible.
Panelists also called on physicians to consider alternatives to oral HRT, such as creams and patches. But they added that there is no clear evidence that nonoral delivery carries fewer risks than the oral drug Prempro, which has been linked to an increased chance of heart attack, breast cancer, and stroke.
Utian says there is good evidence that women who are extremely overweight, diabetic, or have high blood pressure should avoid oral therapy, but it is not clear whether women without specific risk factors need to do so. Utian is a consulting gynecologist at The Cleveland Clinic and an emeritus professor at Case Western Reserve School of Medicine.