Taking a look at hormone replacement risks/benefits

Many women struggle with questions concerning hormone replacement to combat symptoms of all phases of menopause. They are concerned about the risks of hormone replacement therapy compared to the benefits of taking the medication.
 A study by the Women's Health Institute that began in 1996 and ended in 2002 added to the confusion, says Dr. R. Moss Hampton, associate professor and regional chairman at Texas Tech University Health Sciences Center School of Medicine at the Permian Basin.
 "The results showed that some women could be at increased risk for cardio-vascular disease, strokes, blood clots and breast cancer," Dr. Hampton says. "As a result, women stopped taking their medication, sometimes without examining how the medication might benefit them."
 One significant factor often missed in the reports that came out following the study was the average age of the women involved, which was 63½ years. The age of a typical woman entering meno-pause is closer to 50. The fact that these women may already have been at increased risk for cardio-vascular disease due to their age was not taken into consideration, Dr. Hampton notes.
 "The numbers were statistically significant," he says. "Whether or not they were clinically significant is controversial."
 Also overlooked were possible benefits of hormone replacement that the study showed. Women using the combination of premarin and progestin tested in the study had a reduced incidence of colorectal cancer and tended to have fewer fractures from falls.
 Beyond this, women still wanted and needed relief from symptoms caused by menopause including night sweats, hot flashes, vaginal dryness and atrophy, and headaches caused by estrogen deficiency.
 Since the study's release in 2002, doctors have changed the way they prescribe and use hormone replacement therapy.
 "The American College of Obstetricians and Gynecologists recommends that women start hormone replacement as soon as they have symptoms, use it only as long as necessary and taper off gradually," Dr. Hampton says.
 Since the time of the study, doctors have begun using other medications to treat symptoms of menopause. These include bisphosphonates for bone health and SSRI (anti-depressants) for hot flashes.
 Still, he says, "Hormone replacement is the best weapon we have in our arsenal against night sweats and hot flashes."
 Women, in consultation with their doctors, need to determine whether the risk of hormone replacement therapy outweighs the benefits. A woman who knows she is at risk for breast cancer or heart disease would be advised to consider other options.
 "Hormone replacement is not a panacea," Dr. Hampton says. "Women need to watch their cholesterol, have their bone density checked, and schedule regular tests such as mammograms and colonoscopies. Any problems that are detected early can be treated and, often, treated less radically."

Texas Tech Physicians of the Permian Basin is located at 701 W. 5th St. For information or to schedule an appointment, call (432) 335-5233 or the Tanglewood office at (432) 368-3170.