Older Women Should Avoid Hormone Therapy
Study Suggest Women In Their Sixties at Risk
for Heart Disease
By JULIE STEENHUYSEN, Reuters
Posted: 2007-07-12 11:56:05
CHICAGO - Women long past menopause should not use
hormones to prevent heart disease, researchers said.
But mounting evidence suggests hormone therapy may
be useful for women early in menopause looking for
short-term relief from hot flashes and other
menopausal symptoms, another researcher said.
The international study on older women, published in
the British Medical Journal, confirms recent
findings that suggest hormone replacement therapy or
HRT poses risks for women in their sixties just
starting to take it.
"For long-term prevention of chronic diseases,
hormone therapy would really not be advisable," said
Dr. JoAnn Manson, chief of the division of
preventive medicine at Harvard Medical School's
Brigham and Women's Hospital in Boston.
Manson, who was not involved in the British Medical
Journal study, spoke separately at a news briefing
on the latest thinking about hormone replacement
For many years, doctors had thought hormone therapy
could protect women from chronic diseases and
especially from heart disease.
But a 2002 study called the Women's Health
Initiative or WHI raised alarms about heart attack
and stroke risks associated with the therapy,
leading millions of women to abandon HRT.
Now growing evidence suggests these risks are most
pronounced for women who start taking hormones
The latest study, initiated by the UK Medical
Research Council, looked at 5,692 women in Britain,
Australia and New Zealand with an average age of 63
who were about 15 years past menopause.
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HEART BENEFIT STUDIED
The trial started in 1999 and was stopped after the
WHI results were released. The findings show no
overall disease prevention benefit and an increase
in chest pain, heart attacks and blood clots for
older women just starting HRT treatment.
Manson, a member of the Women's Health Initiative
Steering Committee, said the international study --
dubbed WISDOM -- was relatively small compared to
the WHI study.
A new analysis of the WHI study in April suggested
younger women may be able to safely take HRT if they
start treatment within 10 years of menopause.
And a study in the New England Journal of Medicine
last month suggested estrogen might protect younger
women who just entered menopause from heart disease.
Now the WISDOM study concludes that older women do
not get a heart benefit. "Hormone therapy should not
be used for prevention of cardiovascular disease,"
But she said HRT appears to be a reasonable choice
for a recently menopausal woman who has hot flashes
and night sweats that interfere with sleep and
disrupt quality of life.
Manson recommends the lowest effective dose for the
shortest duration necessary because longer-term use
of HRT raises the risk of breast cancer.
"Many women can get by with only three to four years
of treatment, where breast cancer would not be as
great a factor in the benefit-risk equation."
For women with known heart problems, HRT should not
be used, she said.
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