HRT Does Little for Quality of Life
Small Differences Seen in Physical Functioning, Pain, and Sleep
When looking at just the group of women aged 50-59, no substantial quality-of-life improvements were seen whether or not women had taken HRT.
When looking at all women who reported moderate to severe hot flashes, one year of follow-up did show that 77% of women on HRT improved compared with only half of the women on placebo.
Night sweats also improved significantly in women on the progestin-estrogen therapy.
What happened to their hot flashes? "It's partly placebo effect, but it's also the natural process of menopause," Hays said. "Most women do not experience hot flashes five years after menopause. The symptoms do improve over time."
She pointed out the "tremendous variability" among women in their menopausal experience. Some women simply have worse symptoms -- especially hot flashes -- than others. In fact, one study found women in their 70s who were still having hot flashes, she said.
Many women refused to be enrolled in the WHI study because they wanted to keep taking their hormones. "I heard women say, 'This study is so important, but do not take me off my hormones,'" Hays said. "Whether they could function without the hormones or not is another matter. They had the perception that they couldn't."
"I'm sure many women have benefited from HRT," she told WebMD. "Women seek treatment because their symptoms are severe, very bothersome. So there may be some women these results don't apply to. Those are the women most in need of help. We don't want to invalidate the experience of those women."
More research of this major transition in women's lives is needed, said Hays. "There's no such thing as the average woman. There are variations in physical and emotional experiences during this time."
"You should take hormones if you need them," said Laura Corio, MD, a gynecologist at Mount Sinai Medical Center in New York and author of The Change Before The Change: Everything You Need to Know to Stay Healthy in the Decade Before Menopause.
"If you're having night sweats, hot flashes -- terrible symptoms -- you should take them to relieve symptoms," Corio told WebMD when the study results were first released. However, don't take them longer than necessary. "We're not keeping patients on combined therapy long term if there's no reason."