May 31, 2012
Older Women Advised Not To Take Hormone Therapy
Connie K. Ho for RedOrbit.com
Letter grades can be seen in schools, restaurants, and, now, even medical treatments. The U.S. Preventive Task Force recently gave hormone replacement therapy a grade D recommendation. The panel released a recommendation that women who are healthy and past menopause should not use hormone replacement therapy to decrease chances of dementia, bone fractures, and heart disease.
According to CBS News, hormone replacement therapy is usually given to women who report symptoms of menopause such as hot flashes, night sweats, and difficulties of going to sleep. Doctors used to give women after menopause hormone replacement therapy because the treatment was thought to stave off heart disease and osteoporosis. Menopause is thought to affect women between the ages of 45 and 54.
A large part of the recommendation was based off of analyses provided by the Women´s Health Initiative that studied over 160,000 women over a 15-year period. Ten years ago, the initiative first linked hormonal replacement therapy with greater risk of invasive breast cancer and a large number of women decided to stop or avoid hormone therapy as a result. However, in the last few years, there have been studies that state that some postmenopausal women could take hormonal replacement therapy to help against dementia, bone fracture, and heart disease.
Based on the data, the task force found that there was no evidence to support the claim that hormonal therapy reduced heart disease and they found limited evidence that hormones could work against bone fractures. They also found that menopausal women who took hormonal therapy actually had an increased risk of developing dementia. As a result of these findings, the panel decided to weigh new evidence against the risks, such as a higher rate of blood clots in the legs and lungs that were deemed life-threatening, an increased chance of gallbladder disease, and a greater probability of urinary incontinence.
The chairwoman of the panel, Dr. Kirsten Bibbins-Domingo, stated that the group had attempted to consider the benefits of hormone replacement therapy. Estrogen, one method of therapy, was thought to decrease the risk of breast cancer. However, Bibbins-Domingo, a professor of medicine and of epidemiology and biostatistics at the University of California, San Francisco, explained that the consequences that were posed by hormone replacement therapy far outweighed the benefits. The therapy was seen as increasing the possibility of dementia, failing to decrease the chance of heart disease, and was related to a higher risk of having a stroke.
"You would think there wasn't much room for concern," Dr. Rowan Chlebowski, the principal investigator for the Women's Health Initiative and a professor of medicine at UCLA´s Harbor campus, told the Los Angeles Times. "That's not exactly correct."
The recommendation was published in a recent edition of the Annals of Internal Medicine. The task force was asked to look at the risks and benefits of therapies that were thought to prevent illnesses. The panel´s recommendation is likely to be controversial among physicians who do not necessarily believe in the negatives of hormone replacement therapy. In particular, the task force had to evaluate the different risks and benefits of two sets of hormone therapy treatments. Standard hormone therapy, which includes estrogen and progestin, is used by many women. Therapy related to only estrogen refers only to women who have undergone uterus removal.
Overall, physicians believe that the best way to prevent against diseases is to maintain an active and healthy lifestyle.
"There are no magic pills or magic bullets. Get off your butt, eat a healthy diet, don't smoke and lead a healthy lifestyle," Dr. Ranit Mishori, an associate professor at Georgetown University School of Medicine, said in an ABC News segment. "If it's post-menopausal symptoms that bother you, talk to your doctor about short-term treatment with HRT."