Hormone Therapy: Benefit or Danger
By Lennie Martin & Pam Jung
October 2002
Health practitioners and menopausal women are still reeling from
recent studies reporting that hormones, touted as the elixir of youth and
health, caused a significant increase in breast cancer, heart disease and
blood clots in a combination pill called Prempro (Premarin plus Provera).
For years, women had been told by doctors that taking estrogen-progestin
(such as Prempro) would not only ease hot flashes, insomnia, moods and
depression, but would help prevent osteoporosis, heart disease and mental
deterioration. Forty years of studies, however, had conflicting results, and
the specter of breast, uterine and ovarian cancer hovered as a possible risk
of taking hormones.
Some think these latest studies have put much of this confusion to
rest. The Women's Health Initiative (WHI) is a 15-year multimillion dollar
study with 162,000 women age 50-79, conducted by the National Institutes of
Health (NIH). The randomized controlled clinical trial component, considered
the strongest scientific design, enrolled two subgroups of about 16,000
women each: women with a uterus took Prempro or placebo (sugar pill), those
with hysterectomy took Premarin or placebo.
This HRT clinical trial was supposed to last 8-12 years. But after
only 5 years, the NIH called a halt to the Prempro group. The reason why? A
startling result. The women taking Prempro compared to placebo had 41%
increase in strokes, 29% increase in heart attacks, 26% increase in breast
cancer, and 100% increase in blood clots. While there were some benefits
(the Prempro women had 37% reduction in colorectal cancer and 33% reduction
of hip fractures), the NIH investigators did not feel these benefits
outweighed the risks. They concluded that no woman should start or continue
taking Prempro for reducing heart disease or preventing colorectal cancer.
They were equivocal on using it to prevent osteoporosis.
In another study, National Cancer Institute researchers reported an
80% higher risk for ovarian cancer in postmenopausal women taking estrogen
alone for 10 or more years. This rose to an astonishing 220% if they took
estrogen more than 20 years. Most women were taking Premarin.
What should women do about taking hormones?
Become informed. Not all hormones are the same. Premarin is made
from pregnant mare's urine, a very strong mix of estrogens, progestins and
androgens (male hormones). Provera is a synthetic progestin, created in the
chemistry lab. It has many properties of progesterone, but is harsher. There
is, however, a new generation of human identical hormones made from soy,
having the same molecular structure as women's own hormones. They include
estradiol (Estrace, patches, creams) and micronized progesterone
(Prometrium, creams) and don't appear to cause the side effects of Prempro.
But, their long term effects are not known. The WHI is gathering data about
such hormones from 100,000 other women, with results reported in 2007.
Many practitioners are now phasing women off Premarin or Prempro
(quitting cold turkey can throw you back into severe menopause symptoms).
Interest is rising in herbs (black cohosh, vitex), vitamin E, evening
primrose oil and isoflavones to help alleviate symptoms. And some women
whose symptoms are mild are choosing to take nothing at all.
Lennie Martin & Pam Jung, Women at the Gateway 530-265-8064
website: www.womenatthegateway.org
Book: "Taking Charge of the Change: A Holistic Approach to the Three Phases
of Menopause", Delmar, New York, 2002. (at local bookstores)
Classes at Wellness Center, Sierra Nevada Memorial Hospital ($15):
11/6/02, 7-9 pm The Truth About Hormones
11/13/02, 7-9 pm Easing Through the Holidays for Women Who Do Too Much
