HRT studies highlight dangers and benefits

Two studies of hormone replacement therapy, both halted because of adverse results, show the drugs do not prevent heart disease and other chronic conditions.

But health experts said the therapy appeared to be relatively safe and useful at low doses for short periods in treating menopausal symptoms such as hot flushes and night sweats.

"Hormone therapy is not the panacea" once thought, said Marian Limacher, a cardiologist and professor of medicine at the University of Florida, in Gainesville, who was involved in the studies.

And Barbara Alving, director of the United States National Heart, Lung and Blood Institute, said women who had taken hormones for years because they felt good and thought they were protecting themselves against heart disease should seek alternatives.

Details from the researchers' study, which was stopped this year, are being published in the Journal of the American Medical Association.

The research found that oestrogen replacement pills did not reduce women's risk of heart disease, but increased their chances of having a stroke.

They had no significant effect on the risk of breast or colorectal cancer, but did reduce the risk of hip and other fractures.

The study was the second large hormone replacement therapy trial to be stopped.

In July 2002, women taking oestrogen and progestin were told to stop because of the risk of heart attack, stroke and some forms of cancer.

Stephen Hulley and Deborah Grady, physicians at the University of California in San Francisco, made similar comments in an editorial in the AMA journal this week.

Hulley and Grady said hormone therapy was effective for treating menopausal symptoms such as hot flushes and vaginal dryness.

Hormone replacement therapy grew rapidly in popularity, partly because it was thought it might protect against cardiovascular disease, some cancers and brittle bones.

But its use has declined markedly after a series of studies produced alarming results on its side-effects.

The US Food and Drug Administration now recommends that post-menopausal women wanting to use hormone therapy for hot flushes or vaginal dryness take the lowest possible dose for the shortest possible time.

The study published this week involved women over 50 who had hysterectomies and were taking Wyeth's Premarin, made from the urine of pregnant mares.

It found a reduced, but statistically insignificant, risk of breast cancer among women taking oestrogen compared with those given an inert placebo.

Gary Stiles, chief medical officer for the Wyeth company, said the breast cancer result was "perhaps the most striking finding".

"Coupled with the significant decrease in osteoporotic fractures and no overall increase in cardiovascular risk, these findings reinforce the use of oestrogen therapy for its approved indications," he said.

Latest advice

Do: Use for short periods at low doses to relieve hot flushes and night sweats.

Don't: Use for long periods to prevent heart disease - it can increase the possibility of a stroke.

- REUTERS