Estrogen-only therapy may lower breast cancer, heart attack risk for some postmenopausal women
Monday, 9 May 2011
The Los Angeles Times reported on the latest study from the Women’s Health Initiative, which “looked at women who have had hysterectomies and thus can take estrogen unaccompanied by another hormone, progestin,” was published in the Journal of the American Medical Association. According to a report by the AP, the study results bolster, as I’ve stressed in previous blogs, “previous evidence that concerns about breast cancer and heart attacks are largely unfounded for those who take the hormone for a short period of time to relieve hot flashes and other menopause symptoms.”
The researchers examined data from “7,645 of the participants more than four years after they had stopped therapy.” For the women in the study, the slight increased risk for “strokes and blood clots” that was found while they took the pills “disappeared during the follow-up. Unfortunately, the bone-strengthening benefit of estrogen disappeared, too.”
The research also found that women who started taking “estrogen-only pills in their 50s fared better after stopping than women who’d started in their 70s – an age when hormones are generally no longer recommended. … ‘Our results emphasize the need to counsel women about hormone therapy differently depending on their age and hysterectomy status,’” the study authors noted.
The New York Times “Well” blog points out that after using estrogen-only therapy, “certain women had a markedly reduced risk of breast cancer and heart attack.” But, the “most surprising new finding relates to breast cancer.”
The women with hysterectomies who used “estrogen alone had a 23-percent lower risk for breast cancer compared with those who had taken a placebo.” Notably, this is a “stark contrast to the higher risk of breast cancer shown in the estrogen-progestin part of the trial.”
MedPage Today noted that like its “sister WHI trial, which tested combination hormone therapy (CEE plus medroxyprogesterone acetate, MPA) in postmenopausal women, the Estrogen-Alone Trial was stopped early – after a mean of 7.1 years of follow-up – because of a clearly higher rate of adverse effects in the active-treatment group.”
According to a report in HealthDay, the WHI estrogen-alone trial, which included “10,739 postmenopausal women between the ages of 50 and 79,” was to end in 2005, but it was discontinued in “2004 when researchers realized the therapy was causing an increased risk of stroke and no apparent health benefits.”
Meanwhile, the Washington Post reports that an editorial in the same issue of JAMA, authors “Emily Jungheim and Graham Colditz of Washington University School of Medicine in St. Louis wrote that the findings indicate that while there ‘may still be a role for short-term use of unopposed estrogen for treating some women with menopausal symptoms … this role may be vanishing as existing and emerging data continue to be better understood.’”
In the meantime, the standard advice, for women with moderate to severe menopausal symptoms, who understand the potential risks and benefits of hormone therapy, and want to give it a try, is use the lowest dose of hormone for as short a time as possible.
Here are some of my other blogs on the topic over the last year or so: