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More than 50% Have Dropped HRT Treatment

Study Suggests more than Half Stopped, but Many Started Back Again
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WebMD Health News

Oct. 9, 2003 - It has been a little more than a year since women learned the bad news about combined estrogen and progestin hormone replacement therapy. The firestorm of media attention that followed the halting of a major prevention trial left millions of menopausal women wondering what to do.

Now a new study gives one of the first clear pictures of changes in the use of menopausal hormone therapy since the report came out.

A survey of women taking HRT (also known as menopausal hormone therapy) in New Zealand found that more than half -- 58% -- abandoned the treatment after the news reports linked its long-term use to an increased risk for heart disease and breast cancer. But almost one-third of those who stopped started back again, saying they felt better on hormone replacement therapy than off it.

Researcher Beverley Lawton says press accounts unnecessarily confused and frightened women about the risks of HRT. She also questions the way health information is disseminated to the public.

"I think a lot of women panicked, and abruptly stopped hormone therapy because they were distressed by media reports," the Wellington, New Zealand practitioner tells WebMD. "As a woman and a doctor I felt that the way this information was released was really quite frightening."

Women Got the Wrong Impression

The confusion stemmed from the early cessation of a National Institutes of Health trial assessing the use of the estrogen plus progestin treatment Prempro for the prevention of cardiovascular disease. The trial was stopped after it became apparent that a predetermined or pretrial stopping point was reached. Once breast cancer risk was seen to increase past this predetermine or pretrial point, the WHI trial was stopped. Long-term therapy was also linked to a slightly elevated risk for breast cancer, heart disease risk, and blood clots, but it was protective against hip fractures and colorectal cancer.

Investigators concluded that the risks of HRT clearly outweighed the benefits for preventing diseases. They did not suggest that hormone therapy shouldn't be used to treat the symptoms of menopause, but that is the impression that millions of women got, says Wulf H. Utian, MD, PhD, president of the North American Menopause Society.

"Quite honestly, the results from the (trial) could have been reported as the glass is half full or half empty," Utian tells WebMD. "They chose to present them as half empty, and many women have suffered as a result."

Utian agrees that the experience can be seen as an indictment of the way government officials have presented medical information, and he said as much last October during a speech to the NIH leadership.

"I told them that while these data would be discussed and debated for years to come, the manner in which the termination was announced was abrupt, poorly planned, and inhumane," he says. "And I stand by that."

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