Menopause Symptoms Return When Hormones Stop
More Than Half in Study Had Recurrence of Hot Flashes, Night Sweats
July 12, 2005 -- Three years ago this month, millions of women taking menopausal hormone therapy to improve their heart health got the news that the treatment may be doing them more harm than good.
In the months following the unexpected halting of the now famous Women's Health Initiative (WHI) trial in July 2002, many of these older women were abruptly taken off menopausal hormone therapy. Now a look-back study involving WHI participants provides the clearest picture yet of how they fared.
The review found that more than half of the women who reported hot flashes, night sweats, and other menopausal symptoms when they started taking hormones experienced a recurrence of these symptoms after being taken off the therapy.
North American Menopause Society founder and president Wulf Utian, MD, PhD, tells WebMD that it is not uncommon for women to experience hot flashes and other symptoms associated with menopause for a decade or more. He says a small percentage of women have them for the rest of their lives.
"I have women in their 80s and even 90s who still experience hot flashes and other symptoms," he says. "These women may need to stay on hormones indefinitely."
The new study, which appears in the July 13 issue of The Journal of the American Medical Association, shows women taking estrogen or estrogen plus a progestin were six times more likely to report moderate to severe hot flashes and night sweats following discontinuation of treatment compared with women taking placebo.
These women were also more than twice as likely to report an increase in overall stiffness and pain.
The findings came as a surprise to researcher Judith K. Ockene, PhD, because most of the WHI participants were well past the age of menopause when they were taken off hormone therapy.
The average age of the WHI participants when the trial was stopped was 69, and the average time on hormone therapy was 5.7 years.
"The common belief has been that menopause symptoms last for just a few years, but in this study women were older and on hormones much longer," she tells WebMD. "It was a bit of a shock that so many of them still experienced symptoms."
Prior to the publication of the WHI findings, physicians often kept postmenopausal women on estrogen therapy for decades with the belief that the treatment helped reduced their risk of age-related illnesses, including heart disease.
But the large government study revealed that hormone therapy did not prevent heart disease in older women. The study also showed an increased risk of stokes, blood clots, and breast cancer.
Women who don't want to take hormones have options, including lifestyle changes and behavioral interventions, says researcher Diana Petitti, MD, of Kaiser Permanente Southern California.