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February 15th, 2010
05:04 PM ET
Study backs some hormone therapy-heart disease linkBy Jennifer Bixler To take hormones or not to take hormones: That is the question many women going through menopause ask themselves and their doctors. It’s been a topic of debate and discussion for years. Now a new study bolsters previous findings that women who received hormone therapy well into menopause may be at increased risk of heart disease. A team lead by Harvard researcher Dr. Sengwee Darren Toh looked at over 16,000 post-menopausal women. The women were divided into two groups: One received estrogen plus progestin, one of the standard treatments for women going through menopause. The other group received a placebo. Toh and his team found that among women who began combined hormone therapy within a just few years of menopause, which is when women typically begin treatment, "There is no suggestion of a reduced risk of heart disease." But, he adds, "There is also no strong evidence to suggest a significantly increased risk of heart disease among these women either." Toh says that is primarily because their study sample for women who started therapy closer to menopause was small. "We just don't have enough women who were newly menopausal to get definite answers to this question." However, the researchers did find that women who started combined hormone therapy a decade after menopause had an increased risk of heart disease. The findings are published in the February 15th edition of the Annals of Internal Medicine. Why is this important? For decades, hormone replacement therapy has been used to alleviate hot flashes and night sweats, two of the main symptoms of menopause. Doctors also believed that boosting estrogen levels could stop heart disease. However, in recent years, hormone therapy has been mired in controversy. In 2002, the Women’s Health Initiative stopped its clinical trial after researchers found hormone therapy actually posed more risks than benefits. So what does this mean for women “going through the change?” The bottom line, says Toh, consult your doctor and do what works for you. If combined hormone therapy helps with hot flashes, keep it up. The Food and Drug Administration says women who want to try combined hormone therapy should use the lowest dose for the shortest time possible. Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.
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Ihave been on varying types of HRT for ten years. I currently take Enjuvia which works wonders on night sweats (which were horrible) and hot flashes during the day, which were embarrassing and uncomfortable. Recently I was diagnosed with Obstructive Hypertrophic Cardiomyopathy, and some of the diagnostic tests indicated a thickening of the heart muscle so severe it would eventually lead to sudden death. I underwent a Septal Alcohol Ablation and ultimately needed to have a permanent pacemaker implanted. No one has even hinted at a possible connection between HRT and the development of this condition, which might actually be genetic. That being said, I still would not trade the years of relief and comfort that I continue to experience with HRT for the possibility of a heart problem which for me, fortunately, was diagnosed and treated quickly. I am doing fine now.
I have been on estrogen only replacement since menopause onset due to a hysterectomy/oopherectomy due to a massive infection caused by an IUD almost 20 years ago. For the past 8 years I have been on an estrogen patch of the lowest amount, 14 mcg perday, and have been cutting that in half over the past year to wean myself off the estrogen, if possible. In Nov. 2009 I had a cardiac pacemaker implanted because of a lifelong familial low pulse that now in addition is showing EKG changes of RBB block which caused me to faint
.
Your study does not address those women, like myself, who had a surgically induced menopause. Have you examined the relationship between estrogen only HRT and cardiac disease?
This subject really gets me mad. The study done in 2002 by the Women's Health Initiative" had a major flaw in my opinion, and in the opinion of many gynecologists. The average age in the study was 63, about ten years older than the average age of onset of menopause. Well....of course there were more heart attacks/strokes in women of that "average age". So, they stopped the study before it was completed because they saw a slight increase in strokes, in particular, and heart attacks....but not so much an increase in the heart attacks as compared to strokes. Why this was a "surprise" to the researchers is beyond me.....it is only common sense that the average age of the participants would have more incidence of these diseases.
Read the report by ACOG, (American College of Obstetricians and Gynecologists") and decide for yourself. Here is one small sentence from FAQ's on HRT:
"So although the WHI clearly showed that hormones should not be used for disease prevention, they are still appropriate as a treatment for the relief of menopausal symptoms."
http://pagingdrgupta.blogs.cnn.com/2010/02/15/study-backs-some-hormone-therapy-heart-disease-link/?hpt=Sbin
Unfortunately, once the media hooked on to the story of the WHI study in 2002, they panicked every woman in the country who was using HRT to relieve mild to severe menopausal symptoms and the gynecologists saw "a law suit waiting to happen" and most would no longer prescribe the hormones.
I have suffered with severe menopausal symptoms for the last 15 years whenever I have tried to wean myself off HRT. No one has the answer to that., and no one knows how long it would take for the symptoms to subside after you quit HRT. I suffer greatly with not only
hot flashes and night sweats, but severe depression whenever I stopped the HRT. It is appropriate for women with symptoms like this to stay on HRT. It is your choice, and it should be your choice, not the doctors who are afraid of lawsuits if they keep prescribing it even in appropriate situations.....all based on a flawed study!!
I agree with Marsha, who had a surgically induced menopause, that we need more studies of women who are on estrogen only (not combined with progestin). I too have been on estrogen for a number of years due to a hysterectomy/ooectomy for fibroids when I was 50. I recently switched to the lowest dosage of the patch and have experienced hot flashes at night and general low-grade fatigue and depression. There also need to be studies of the difference between women who have had both ovaries and uterus removed, and those who have only the uterus removed. It seems to me that women with intact ovaries would have higher levels of estrogen, while women without would need more, but I have never seen any guidelines about this, and believe me I have looked.
you can also reduce the sypmtoms of menopause by having hormone replacement therapy.";
menopause symptoms can be remedied by hormone replacement therapy~`~
menoupause sometimes comes at an early age specially if the person is very stressed:,"
when a woman comes into the menopausal age, her skin deteriorates as well as her sexual functions-*'
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