Younger women may
be able to take hormone replacement therapy without
raising their risk of heart disease, U.S. researchers
reported on Monday in a study aimed at reducing some
of the confusion surrounding HRT. In fact, the therapy
may even lower their risk.
Women who started
taking the drugs as they began menopause—which
typically starts in the mid 40s and lasts through the mid
50s—had a 30% lower risk of heart disease than
women who did not take them, the researchers found.
contrast with those of a highly publicized 2002 study called
the Women's Health Initiative, or WHI, which found HRT
raised the risk of heart attack, stroke, breast
cancer, and other serious conditions. After it came
out, millions of women stopped HRT and sought alternatives.
"It may help to
untangle some of the confusion," said JoAnn Manson of
Harvard Medical School and Brigham and Women's Hospital in
Boston, who worked on both studies.
After the 2002
Women's Health Initiative was published, experts cautioned
women to only take HRT in the lowest possible doses and for
the shortest possible time. Sales of Wyeth's Premarin
and the company's other female hormone replacement
drug, Prempro, fell dramatically, and the company, the
biggest maker of HRT, announced plans to close at least one
plant and to lay off sales staff.
But HRT remained
popular in part because doctors had observed that women
taking the drugs were less likely to have heart disease over
the long term. Manson and others who worked on the WHI
study noted that participants were on average
63—a decade past menopause.
what would happen with younger women just entering
So they used data
from the Nurses' Health Study, an ongoing study of
121,700 female nurses, ages 30 to 55 when it started in
1976. Every two years these women have filled out
detailed questionnaires on their health, habits, and
medications. When they died, their medical records
were carefully evaluated.
The nurses' data
showed that if women took HRT at younger ages, they had
a 30% lower risk of heart disease than women of the same age
who did not take HRT.
"It does suggest
that women who are good candidates for hormone
therapy—because they are recently menopausal and
having moderate to severe hot flashes and are at low
risk of heart disease—may not need to be
alarmed about the [earlier] findings," Manson said in a
telephone interview. "The evidence is beginning to
converge. But it is certainly not conclusive. We don't
want people running out and taking hormone therapy and
thinking it was going to protect their heart and that
there are no risks involved."
Writing in the
Journal of Women's Health, Manson and
colleagues stress that more research is needed.
The 2002 findings
have caused doctors to take a fresh look at menopause,
and many have criticized the idea that it is a medical
condition that needs drug treatment.
suggest many symptoms attributed to menopause may be natural
consequences of aging, including reduced libido, higher risk
of heart attack, and forgetfulness.
have suggested the formulation of HRT may be a factor.
Women in both the 2002 and the 2006 studies mostly took
Premarin or Prempro, which are made using the urine of
pregnant horses. (Reuters)