Gynecologists Discuss The Risks/Benefits

Of Hormone Replacement Therapy

DANBURY –– Hormone replacement therapy (HRT) for women in menopause has caused some confusion lately, especially since last year’s announcement that hormones were not as effective as once thought to be, and could cause more harm than good.

Doctors at Danbury Hospital speaking at a recent Medical Town Meeting, “Get the Facts on Women and Cancer,” tried to clear up some of the confusion, advising women to learn about HRT and make individual choices for themselves.

“My final advice: It depends on you,” said Dr Thampu Kumar, chief of benign gynecology and gynecological oncology at the hospital. He reminded women that when it comes to medications, no two women are alike and not everyone responds the same way. He did warn women with a family history of breast cancer, however, to think carefully about going on HRT.

Dr John McGrade, an attending physician in the Department of Obstetrics and Gynecology, had a similar message. Dr McGrade reviewed the history of HRT use in the United States since the 1960s and pointed out the pros and cons of the Women’s Health Initiative (WHI), one of the largest preventive studies of its kind in the United States on the major causes of death, disability, and frailty in postmenopausal women. WHI’s goal is to reduce coronary heart disease, breast and colorectal cancer, and osteoporotic fractures among postmenopausal women through prevention, intervention, and risk identification. The 15-year initiative, launched in 1991, has been studying the effects of HRT on breast cancer, coronary artery disease, osteoporosis, and quality of life issues associated with menopause, such as hot flashes and night sweats. In July 2002, the study announced its findings that HRT had too many adverse effects.

While the study has concluded that HRT helps reduce the incidence of osteoporosis, according to Dr Howard Blanchette, chairman of the Department of Obstetrics and Gynecology, moderator of the meeting, it has not proven successful in reducing the risk of heart disease.

“The evidence shows that estrogen promotes the retardation of osteoporosis, but the case isn’t made in heart disease,” added Dr McGrade. But doctors have continued to find HRT helpful in alleviating some of the symptoms of menopause, including hot flashes, night sweats, and sleep problems. Dr McGrade also said that its benefit in these cases is questionable. In June, a WHI publication will report that HRT has no benefit in helping quality of life issues, according to Dr McGrade.

The doctors did advise women to practice a healthy lifestyle by controlling weight, exercising, not smoking, limiting alcohol use, and eating a healthy diet.