HRT Linked to Shorter but Better-Quality Life
Short-Term Hormone Therapy Can Shorten Life by Weeks but Improve Quality
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WHI Revisited continued...
Women with mild symptoms gained from three to four months of life expectancy and quality of life. The increased expectancy was found in women regardless of their risk of heart disease.
The researchers found that the longer hormones are used to relieve symptoms, the larger the gains in quality of life. According to the model, even women at high risk of heart disease gained more than eight months in quality of life by increasing hormone therapy from two years to five years.
"If the only goal were to maximize survival then nobody should take hormone therapy," Col says. "But for most women who are considering it for symptom relief, quality of life is the main consideration."
While warning that women who have an extremely high risk for heart disease may not be good candidates for the therapy, Col says the benefits of short-term hormone therapy use appear to outweigh the risks for most symptomatic women.
'On the Same Page'
North American Menopause Society President Wulf Utian, MD, PhD, agrees, but he says the newly developed computer model adds little to the clinical picture.
The model uses WHI data to simulate the effects of short-term hormone use on 50-year-old menopausal women. Utian points out that the vast majority of women participating in the WHI were much older and very few of them had symptoms related to menopause.
While a clear increased risk for blood clots has been shown with short-term use of hormones, there is little clinical evidence for an increase in heart attack or breast cancer risk with short-term use, Utian says. And there is absolutely no evidence indicating an increased risk of death from heart disease among younger women taking hormones for symptom relief.
For the last three years, Utian has led the North American Menopause Society's advisory panel on hormone therapy. The group is finalizing its 2004 report.
"It seems more and more that we are all on the same page in saying that symptomatic women shouldn't be concerned about taking hormone therapy for one, two, or even three years," he says.