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Study Finds Hormone Replacement Therapy Risks Greater Than Benefits

By Thomas H. Maugh II and Rosie Mestel
LOS ANGELES TIMES -- A major new study of 16,000 women has found that hormone replacement therapy does not improve the quality of life for post-menopausal women, a finding that may sound the death knell for widespread use of a treatment once thought to be a panacea for women’s ailments.

Last year, a related study indicated that the risk of heart disease and cancer associated with the use of combined estrogen-progestin treatment outweighed potential benefits, but many women continued to take the drugs because they believed it made them feel better overall.

The new study, however, gives the lie to those beliefs. Even among women who had a reduction in menopausal symptoms, quality of life measures were as high for women taking a placebo as for those taking the drugs, the researchers found.

“There is no role for hormone therapy in the treatment of women without menopausal symptoms,” said Dr. Deborah Grady of the University of California, San Francisco, who wrote an editorial accompanying the report, which will be published in the New England Journal of Medicine in two months. The report was released early because of its medical importance.

“The average woman will not experience an improvement in her quality of life by taking this pill,” added Dr. Jennifer Hayes of the Baylor College of Medicine, who led the study. Quality of life includes a broad variety of factors, such as depression, cognitive functioning, sleep and sexual satisfaction, as opposed to the hot flashes and night sweats typical of menopause.

Hayes said that women can use the therapy to reduce the symptoms of menopause, but that they should use the lowest possible dose and stop taking the drugs as soon as possible.

Proponents remained unswayed by the new evidence, however. “That’s not true, it’s not true,” said Marie Lagano, founder and president of the American Menopause Foundation in New York City. “We’ve met women who have been on hormone therapy for 20 years. They look great and feel great, and have no intentions of stopping hormone therapy.”

Dr. Alan Altman of the Harvard Medical School added: “Any health-care provider who has treated post-menopausal women over the past 25 years knows that the clear benefit of individualized hormone replacement therapy to quality of life is indisputable.”

Hayes countered, however, that “the perception of the benefits has far outstripped the research documenting those benefits.”

Before the Women’s Health Initiative study began, she said, researchers believed hormone therapy was beneficial to the heart and that the study would reveal how that benefit compared to the risks of therapy. What they found instead was a risk to the heart.