The risks associated with hormone replacement therapy are not as great as commonly believed, and women in the early stages of menopause should not worry about taking the drugs, according to Amos Pines, chair of the International Menopause Society, who issued a consensus statement from a team of experts who reviewed the safety and effectiveness of HRT in early menopause, Reuters reports. The statement was issued at a global summit in Madrid on Tuesday (Kahn, Reuters, 5/20).
NIH researchers in July 2002 ended the Women’s Health Initiative study of combination HRT three years earlier than scheduled because they determined that the treatment might increase the risk for heart disease, invasive breast cancer and other health problems (Daily Women’s Health Policy Report, 3/5). The results of the study, which also found HRT increased the risk of ovarian cancer and strokes, caused millions of women to end their use of the drugs.
Pines said that he and colleagues reviewed numerous related studies of women who took HRT and found no increase in the risk of heart disease among women between ages 50 and 59. Pines also said the WHI study was flawed because the study group was relatively old and had other conditions that increased the risk of health problems. According to the research team, some types of HRT can slightly increase breast cancer risk, but the risk is minimal in comparison to other risks such as smoking or having a first child after age 30.
Pines said, “The message is that each woman should discuss her general health, and risk factors such as family history … with her doctor, but, generally, healthy women entering menopause should not have fears.” However, Valerie Beral, an epidemiologist at the University of Oxford, said the IMS review was not valid because it only looked at a fraction of the evidence, adding that regulatory bodies worldwide recommend HRT only for short-term use. IMS’ review only “quote[s] a small number of the very large studies that have been done,” Beral said, adding, “The review does not agree with regulatory bodies in the United Kingdom, U.S. or Europe who have reviewed the totality of the evidence” (Reuters, 5/20).
IMS President David Sturdee said that common “misperceptions” surrounding HRT have resulted in many women having difficulty coping with menopausal symptoms and that women should take the drugs “for as long as they need to be on it.” He added, “HRT is the most effective treatment for menopausal symptoms, but press reports over the last few years have made it difficult for many women to consider its use” (BBC News, 5/20).
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