Hormone Therapy Won't Prevent Disease After Menopause: Analysis
But follow-up research shows that short-term use for hot flashes remains an option
By Amy Norton
TUESDAY, Oct. 1 (HealthDay News) -- No good evidence supports using hormone replacement therapy after menopause to prevent heart disease or other chronic ills, but short-term use for hot flashes should be an option.
That's the conclusion of the latest analysis of the Women's Health Initiative (WHI), a group of major U.S. trials set up to test use of hormone replacement therapy for preventing chronic diseases in healthy, older women.
The WHI was launched in the 1990s, at a time when doctors were prescribing hormone replacement therapy to postmenopausal women to ward off heart disease. The results changed common practice, however.
In 2002, one of the trials was stopped early when researchers found that women taking the hormones -- estrogen-plus-progestin pills -- actually had higher risks of blood clots, heart attack, stroke and breast cancer than placebo users did.
A second trial, looking at estrogen therapy alone, was stopped two years later. Women on the hormone showed no lower risk of heart disease, but did have a slightly elevated rate of blood clots and stroke.
The latest findings, published in the Oct. 2 issue of the Journal of the American Medical Association, do nothing to change the general advice on hormones, according to lead researcher Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital in Boston.
"Hormone therapy is not indicated for long-term disease prevention," Manson said.
On the other hand, for women who have recently gone through menopause and are suffering from severe hot flashes, hormone therapy is still the most effective remedy. So short-term use "may be appropriate" for those women, Manson said.
That's not a new recommendation; experts have long said that short-term hormone therapy should be an option for severe hot flashes. But these latest results bolster the belief that hormone therapy is safer for relatively younger women who use it for a finite time, Manson said.
She noted that some doctors seem to have had a "misunderstanding" regarding the original WHI findings, and are reluctant to use hormone therapy even for hot flashes.