Hormone Therapy: Risky, but Still an Option to Treat Hot Flashes

Monday, August 04, 2003

ROCHESTER, Minn. — More than a year ago a study became news and changed how women and their doctors view hormone therapy after menopause. The Women's Health Initiative study found that a combination of estrogen and progestin resulted in more risks than benefits for menopausal women. Increased risks were noted for heart attacks, breast cancer, stroke and blood clots. About 36 percent of women taking Prempro, the hormone therapy being studied, stopped using it within four months of the announcement.

Additional risks have been identified since then. The risk of dementia was double among Prempro users age 65 and older. Researchers found hormone therapy didn't improve quality of life measures such as energy, mental health, depression, memory or sexual function, except in women with severe hot flashes.

If you opt to continue hormone therapy, Mayo Clinic Women's HealthSource recommends you take preventive measures including yearly breast exams and mammograms. Reduce your risk of heart disease with a low saturated-fat diet, regular exercise and not smoking.

Talk with your doctor about the following steps that might be beneficial. However, no one knows if or how much these steps reduce the risks of hormone therapy.

* Take a lower-dose product. Many are available.

* If you need progestin, consider micronized progesterone (Prometrium). It has fewer adverse effects on cholesterol levels than do synthetic forms of the hormone. Also, consider taking it cyclically. One regimen is taking it 12 to 14 days every three months. This provides less exposure to the progestin hormone which has been found to increase breast cancer risk more than estrogen alone.

* Consider a hormone patch instead of pills. Estrogen-patch therapy doesn't adversely affect blood clotting the way estrogen pills do.

Mayo Clinic in Rochester
Carol Lammers
507-284-5005 (days)
507-284-2511(evenings)
email: newsbureau@mayo.edu

Mayo Clinic in Jacksonville
Erik Kaldor
904-953-2299

Mayo Clinic in Scottsdale
Anne Tewksbury
480-301-4368

Mayo Clinic Women's HealthSource is published monthly to help women enjoy healthier, more productive lives. Revenue from subscriptions is used to support medical research at Mayo Clinic. To subscribe, please call 800-876-8633, extension 9PK1.

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