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Risks of Hormones in Early Menopause Challenged

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Weighing Benefits and Risks

The study found that both forms of hormone therapy relieved menopausal symptoms like hot flashes and night sweats better than the placebo. Hormones also showed significant benefits for sexual health. Both pain with intercourse and vaginal dryness improved in women taking estrogen. Women on the patch, but not the pill, saw increases in their libido.

Hormone therapy had a mixed effect on some measures of heart health. Hormones didn’t raise blood pressure, as had been seen in other studies. Women taking hormones also had small, positive changes in their cholesterol, with an increase in good cholesterol, HDL, and a decrease in bad LDL levels, compared to women on the placebo. But hormones also raised blood fats called triglycerides and C-reactive protein, an indicator of inflammation. Both markers are linked to an increased risk of heart disease.

Nearly 700 women agreed to participate in the part of the study that looked at mental function. They took tests at the start of the study and at 18, 36, and 48 months, designed to measure mood and memory.

“We found symptoms related to depression were significantly improved for women who got the oral form of estrogen. The skin patch [on the] arm didn’t show benefits or harm for mood,” Asthana says.

Estrogen pills, but not patches, seemed to improve anxiety and tension compared to a placebo, he says.

Women on hormones in the KEEPS study showed no memory loss over the course of the study. That was a relief, Asthana says, because the WHI found that women taking hormones were at higher risk for dementia than those who did not take them.

But he acknowledges that four years may not be enough time to measure meaningful changes to memory.

Safety Issues

The women in the KEEPS study were also more than a decade younger than women in the WHI. Hormones may affect the brain in ways that may only show up as women age, says Rowan T. Chlebowski, MD, PhD, a medical oncologist at the David Geffen School of Medicine at UCLA.

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