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Hormone Replacement Therapy (HRT): New Risks Revealed

Years ago, there was a debate about HRT. Should women be taking these hormones to help them combat menopausal symptoms such as hot flashes, night sweats, vaginal dryness and in some cases, to prevent osteoporosis? In 1991, the U.S. National Institutes of Health (NIH) launched the Women's Health Initiative (WHI) - the biggest and most robust study of its kind - to investigate the potential benefits and risks of HRT. Five years after the start of the study, the NIH prematurely ended one arm of the study. It was found that those women taking combined estrogen and progestin pills had more health risks than benefits. Analysis of the data found that for every 10,000 women on HRT vs. placebo during a one year period:

Risks:
  • Seven more cases of coronary heart disease (37 on combined HRT versus 30 on placebo)
  • Eight more cases of strokes (29 vs 21)
  • Eighteen more cases (34 vs 16) and a twofold greater rate of total blood clots in the lungs and legs
  • Eight more cases of invasive breast cancer (38 vs 30)
  • 23 more cases of dementia (45 vs 22)
Benefits:
  • Six fewer cases of colorectal cancer (10 vs 16)
  • Five fewer cases of hip fractures (10 vs 15)
After 7 years, the estrogen only arm of the WHI study was discontinued. They concluded that this therapy:
  • did not increase or decrease the risk of coronary heart disease;
  • did not increase risk of breast cancer;
  • increased the risk of stroke similar to the findings reported from the WHI estrogen and progestin arm of the study; and
  • decreased the risk of hip fracture, in women who have undergone hysterectomy.
  • shows trend toward increased risk of probable dementia and mild cognitive impairment
The researchers continue to follow-up on the patients in the study and the latest news shows that:
  • heart problems linked with the pills seem to fade after women stop taking them
  • the health benefits of decreased hip fractures and colorectal cancers also faded after women stopped taking the pills
  • however, surprising new cancer risks, in particular lung and breast tumours, seem to have caught scientists off guard. Those who'd taken the hormones and stopped were 24 percent more likely to develop any kind of cancer than women who'd taken the placebo. That amounts to three extra cases per year for every 1,000 women on hormone pills vs. placebo.
As the years go on, we'll learn even more from this study as follow-up data is accumulated and analyzed. But for now, health risks from estrogen-progestin pills seem to outweigh their benefits. Some doctors continue to prescribe these pills to relieve hot flashes and other menopause symptoms, in addition to building bone strength. For those women who continue to take these pills, I definitely recommend the lowest possible dose for the shortest duration possible. But if I were you, I would exhaust all other safe, more natural alternatives before going on these synthetic hormones. There are many ways to build bone density and to decrease your menopausal symptoms. Of course, go to a knowledgeable health care professional that you know.

Yours in Health as always.

1 comment:

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