Estrogen Discouraged for Disease Prevention
Risk Appears Low for Younger Women
Although the reduced hip fracture findings from the WHI study are encouraging, the experts agreed that most women are better off taking other drugs approved for the prevention and treatment of osteoporosis, a common contributor to hip fractures.
"There are also intriguing findings starting to emerge suggesting that the dose of estrogen needed (to protect bones) is much lower than what is currently being given for osteoporosis prevention," WHI project officer Jacques Rossouw, MD, said during the news conference.
Studies have suggested that the increase in heart disease and stroke risk associated with menopausal hormone therapy may be confined to older women who are well past menopause before starting hormone therapy. Rossouw said that the risk of short-term use among younger women "is likely to be very low."
In a prepared statement, Premarin's manufacturer, Wyeth, points out that the average age of the women in the current study was 63 and says that in preliminary analysis of the study results, "it appears that the risks monitored in WHI were lower for women aged 50-59 and increased with age.
"While these results should be interpreted with caution, they appear to suggest that [Premarin] may have a more favorable risk profile for younger versus older women," says Wyeth.
Wyeth is a WebMD sponsor.
All experts agree, however, that women who are still taking hormones to protect against heart disease need to look to other interventions.
"Cardiovascular disease is the leading killer of women," said WHI principal investigator Marian Limacher, MD. "We have very effective treatments to reduce the risk of heart disease and stroke, and these are the treatments that women should be focusing on."
A practicing cardiologist, Limacher said these treatments include drugs to lower blood pressure and cholesterol, as well as highly effective lifestyle interventions like losing weight, getting more exercise, and stopping smoking.
"As a nation we are in terrible shape, and as a nation we are also becoming more and more obese," she said. "So weight management, diet control, and exercise are high on the (cardiovascular disease prevention) list."