Women told HRT does not lead to early death

Dr. Jo Ann E. Manson chief of preventive medicine at Brigham and Women's Hospital and longtime research leader on hormone therapy

Anderson said the risks and benefits for hormone replacement therapies should always be considered; this newest study adds another layer of information about mortality risks that a woman and her doctor can use when considering treatment options.

The 2002 report found that hormone replacement therapy increased women's risk of breast cancer and stroke, Lichtenfeld said.

The new update shows that women are not more likely to die after using hormone replacement therapy, even if the therapy increases their risk of health problems such as breast cancer, stroke and heart disease, Lichtenfeld said.

"This is good news for women", said JoAnn Manson, professor of medicine at Harvard Medical School and lead author of the study.

Women who took estrogen for an average of seven years or combination estrogen and progesterone therapy for an average of five years had no increased risk of death after 18 years of follow-up, compared with women given an inactive placebo, the researchers found.

A long-term follow-up of more than 27,000 women who were part of the Women's Health Initiative found no link between hormone therapies used in the landmark study and deaths from cardiovascular disease, cancer or other major illnesses.

"It's the ultimate bottom line, ' said Manson, who was also part of the original research". After that, many doctors became reluctant to prescribe hormone therapy for menopause symptoms. "However, the findings do not provide support for the use of hormone therapy for the prevention of cardiovascular disease or other chronic diseases".

The study, published in the journal JAMA, is the first to examine long-term death rates from all causes among women who received the hormone therapies.

After 18 years, which included 10 to 12 years of follow-up after stopping hormone therapy, the differences by age group diminished and were no longer statistically significant.

The researchers also found that deaths from Alzheimer's disease and other forms of dementia were significantly lower with estrogen alone than with placebo during 18 years of follow-up, but use of estrogen plus progestin was not associated with dementia mortality.

"We observed a trend toward reduced mortality in younger women (age 50-59) who received hormone therapy, and neutral effects in older women (in their 60s and 70s) who received hormone therapy".

Researchers say the data support guidelines that say hormones may be appropriate for some women when used short-term to relieve hot flashes and other symptoms.

"This study does not mean that a woman can nonchalantly start hormone therapy and stay on it for the rest of her life", he said.

Today, there are new formulations of hormone therapies, which include lower doses and novel administration methods, such as skin patches, gels, and sprays. Additional research on the long-term benefits and risks of these newer treatments is needed, the researchers say.



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