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Women's Health: Hormones safe for many women managing menopause

Doctors endorse short-term treatment of hot flashes and night sweats, but recommend regular checkups

Several years ago, a study called the Women’s Health Initiative (WHI) dealt a serious blow to the idea that long-term hormone replacement therapy was beneficial for postmenopausal women. But a second look at the results of that same study reveals that short-term treatment within 10 years of menopause is a safer option.

The WHI involved more than 27,000 postmenopausal women in the U.S. and was stopped in 2002 due to increased risks of heart disease, stroke and breast cancer in the women taking hormone therapy — risks that outweighed a beneficial reduction in hip fractures and menopausal symptoms.

But a new analysis of the study shows that women who want to reduce menopausal symptoms such as hot flashes can take up to five years of hormone therapy within 10 years of menopause without increasing their risk for heart disease. However, risk of stroke and risk of breast cancer are not affected by age or by time since menopause.

“For women close to the menopause, it’s a reasonable option to use hormones in the short term, but they should check their blood pressure and have it treated, and they should have their mammograms,” says Dr. Jacques Rossouw, chief of the Women’s Health Initiative Branch at the National Heart, Lung and Blood Institute in Bethesda, Md.

“For older women it’s not a good option. In fact, particularly if they have hot flashes and night sweats, because data indicate that those older women who have persistent hot flashes and night sweats have a lot of risk factors such as high blood pressure, high blood cholesterol, diabetes.”

These results confirm what many doctors have long suspected.

“Our clinical recommendations . . . have anticipated this,” says Dr. Jennifer Blake, chief of obstetrics and gynecology at Sunnybrook Health Sciences Centre in Toronto, and principal author of the Society of Obstetricians and Gynecologists of Canada’s consensus report on menopause.

She says some interpretations of the original WHI data may have made the large group of baby boomers approaching menopause fearful of a treatment that could have been helpful to them. “The new analyses may ease that anxiety.”