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by Julie Calligaro
In Our Store
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If you are using hormones or considering the use of hormones to combat hot flashes and other symptoms of menopause, you may be confused by the various reports released by the Women's Health Initiative (WHI). The WHI was a government study of more than 27,000 women designed to study the effects of hormones on heart disease. In 2002 the WHI halted one part of the study reporting that, rather than decrease the risk of heart attacks, estrogen plus progestin actually increased the risk by 29%. They also reported a 24% higher risk of breast cancer.
Two years later the WHI halted the estrogen only part of the study because estrogen alone did not appear to affect (either decrease or increase) the risk of heart disease. But of greater importance, the risk of stroke increased by 40%.
The government initially said that these findings applied to all women regardless of age and health status. Since those initial reports, however, the WHI reanalyzed the data. It now appears that the risks and benefits of using hormones vary depending on the woman's age when she starts taking hormones.
For example
- Women age 50-59 have a 7% lower risk of heart attack and a 13% higher risk of stroke as compared to women who don't use hormones.
- Women age 60-69 have a 2% lower risk of heart attack and a 50% higher risk of stroke.
- Women 70-79 have a 26% higher risk of heart attack and a 21% higher risk of stroke.
Key questions about the long-term use of hormones are still unanswered. While the WHI data clearly shows that starting hormones at a later age is risky, it's unclear whether the cardiac protection women experience by starting hormones at a younger age will continue with long-term use. Fortunately there are two important ongoing studies that should help clarify the role estrogen plays in heart disease, so stay tuned.
For the time being, if you are using hormones to treat hot flashes and other symptoms of menopause, use the lowest dose that helps for the shortest period of time. And don't forget regular check-ups, pap smears, breast exams, calcium and vitamin D.
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