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Wednesday, February 15, 2006 - The Ups and Downs of Hormone Replacement Therapy and Menopause Relief
The Ups and Downs of Hormone Replacement Therapy
and Menopause Relief
VINELAND, NJ (February 15) – Hormone replacement therapy (HRT) was once the treatment of choice for relieving uncomfortable symptoms of menopause as well as reducing the risk of osteoporosis and possibly heart disease. In 2002, however, studies resulting from the National Institutes of Health Women’s Health Initiative linked HRT to increased risk of breast and ovarian cancers. The cancer risk was higher in women who used HRT for several years.

Moreover, the Women’s Health Initiative also found an increased risk of heart attacks and stroke in women taking combined estrogen and progestin. Another large clinical trial for women with a history of heart disease found a lower risk after three years on HRT, but long-term follow-up showed that HRT produced no overall reduction in the risk of heart attacks. Heart disease is the leading cause of death among women in this country.

One result of these findings was that women sought other means of relieving hot flashes and protecting their hearts. Natural compounds, such as soy products and the isoflavones they contain, have been promoted as remedies to ease menopause-related discomfort and reduce "bad cholesterol" (low-density lipoproteins).

However, the American Heart Association’s new analysis of 22 soy studies found no evidence for many of the claims made for soy, including relief of hot flashes as well as reduction of risk factors for heart disease such as lowering cholesterol and blood pressure (Feb. 16, 2006, Circulation: Journal of the American Heart Association). The soy worked no better than an inactive pill, or placebo.

To assure relief of hot flashes, doctors still prescribe hormone replacement for patients who demonstrate a need for it. For some women, hormone replacement therapy may be the only feasible solution.

"The most important factors to consider when thinking about hormone replacement therapy are

personal and family history," says Dr. Ronald Pomante, a board-certified gynecologist on staff at South Jersey Healthcare. "Ultimately, it’s a decision to be made between the patient and her physician."

Doctors are evaluating potential HRT candidates for the severity of menopausal symptoms as well as their health and family history before prescribing hormones to women at a higher risk of developing cancer.

"Patients who are receiving hormone replacement therapy today are getting a much lower dose than was commonly used in studies five years ago," said Pomante. "Patients are also using the therapy for shorter periods of time. The key is to use the lowest possible dose for the shortest possible time. The results of the Women’s Health Initiative are being intensely scrutinized and the final word has not been written yet."

Women who start the therapy soon after menopause may even benefit their heart. Based on data from the Nurses Health Study, a report in January 2006 Journal of Women’s Health notes that HRT reduced the risk of heart disease by 30 percent in women who began the therapy near menopause and had no prior history of heart disease. In contrast, 2003 Women’s Health Initiative study included women more than 10 years past menopause.

To learn more about cancer, call the SJH Frank and Edith Scarpa Regional Cancer Pavilion at (856) 575-4430.

SJH Cancer Services, located in the Frank and Edith Scarpa Regional Cancer Pavilion, have been an affiliate of the Fox Chase Cancer Center since 1995. SJH offers the only cancer program in Cumberland, Salem, or Gloucester counties designated as a Community Hospital Comprehensive Cancer Program by the American College of Surgeons – Commission on Cancer.

The SJH team of board-certified physicians, registered radiation therapists and nationally-certified oncology nurses have provided state-of-the-art radiation therapy, medical oncology and cancer support services to thousands of patients in the region for more than 25 years.

SJH is a nonprofit, integrated health care system, providing access to a continuum of health services. SJH provides hospital services, numerous community health clinics, home health services, and specialty services, which serve the medical and health care needs of Southern New Jersey residents.