Blow to hormone replacement therapy

BOSTON - Now there is one less reason for women to take hormones after menopause, researchers say.

A study of more than 16,000 people found that treating women with oestrogen and progestogen did little to enhance their quality of life unless the hormones were being used as a short-term therapy to block hot flushes and night sweats.

Debate has raged for years over the wisdom of hormone therapy, amid conflicting reports over whether it prevents brittle bone disease and heart disease. But the new findings, released nearly two months before schedule by the editors of the New England Journal of Medicine because of their health implications, suggest most older women should not take the hormones because the risks outweigh the benefits.

"There is no role for hormone therapy in the treatment of women without menopausal symptoms," said Deborah Grady, of the University of California at San Francisco, in an editorial about the findings.

Hormone treatments may be justified for women who find hot flushes and night sweats disabling. But only 10 to 20 per cent fall into that category and they should be started on a low dose that is gradually increased until the symptoms disappear, she said.

Deborah Grady said the overall harm outweighed the benefits. One in 100 women treated for five years will suffer a serious complication from the hormone treatments.

One argument for taking the hormones had been that they make older women feel better. "This claim has now been laid to rest by the new results," she said.

The authors of the new study, led by Jennifer Hays of the Baylor College of Medicine in Houston, found that any physical or emotional improvements felt by the 8506 women who got the hormones were not meaningful and faded after the first year.

The 8102 women receiving placebos had the same levels of sexual activity, insomnia and depression as women who received the oestrogen and progestogen.

Some previous findings indicated the oestrogen-progestogen combination produced small declines in hip fractures and colon cancer, even as it increased the risk of stroke, breast cancer, heart attack, and blood clots in the lungs.

Women and hormones

* US researchers studied more than 16,000 women. They released their results two months early because of the health implications for women using hormones.

* Results show that treating women with oestrogen and progestogen does little to enhance quality of life unless the hormones are used short-term to block hot flushes and night sweats.

* Any physical or emotional improvements felt by women who got the hormones faded after the first year.

* Women who received placebos had the same levels of sexual activity, insomnia and depression.

* Some previous findings indicated the oestrogen-progestogen combination produced small declines in hip fractures and colon cancer but increased risk of stroke, breast cancer, heart attack and blood clots in the lungs.

Source: New England Journal of Medicine

- REUTERS