Tuesday, May 27, 2008

HRT: More Unpredictable than Hormones Themselves

Hot flashes. Insomnia. Mood swings. Decreased sex drive. Women between the ages of 45 and 55 describe it as pure hell. Menopause is a natural biological process that all women are forced to endure at some point in their lives. But, what is natural about it? Almost all women experience symptoms of menopause. For some, however, the symptoms are severe with no relief in sight, and women look to their doctors for help.

Hormone Replacement Therapy (HRT) came into the picture as a safe treatment for menopausal symptoms in 1942 with the marketing of Premarin™, followed by other treatments such as Prempro™. These medications contain one or more synthetic female hormones, commonly known as estrogen and progesterone. Premarin holds the crown for being the most widely prescribed drug in the United States because of its effectiveness in making menopausal women happy again.

The Women's Health Initiative (WHI) was a national health study launched in 1991 during the heyday of HRT prescriptions. According to the study, the clinical trials were designed to test the effects of HRT, diet, and supplementation on prevention of heart disease, fractures, and breast and colorectal cancer. The 15-year project involved over 161,000 women ages 50-79, and is considered one of the most definitive, comprehensive programs of women's health research ever done in the United States. Participants in the WHI trials were randomly assigned hormone medication or placebo. However, the NIH halted the study early because the health risks participants experienced outweighed the health benefits. Women taking the hormones did see some benefits, but they greatly increased their risk for breast cancer, heart attacks, strokes, and blood clots.

Menopausal women and their physicians felt betrayed. How could something with such a long standing history as being the women's miracle menopause cure now be proven to be unsafe? The results of the study compelled many physicians and women to abandon HRT and try to come up with alternatives with little to no avail. Think about trying to explain to a menopausal woman in mid-hot flash that if she dresses in layers and refrains from caffeine and alcohol, she'll feel back to her pre-menopausal self in no time...hide the knives!

Now, a recent ABC News article reports that an international panel of experts are giving the green light for HRT again. This change of heart comes after researchers revealed that the WHI was flawed. Participants in the trials did not accurately represent the menopausal population, with the majority being relatively old and suffering from other conditions that all boosted risk. The panel has agreed that HRT is safe and effective for short term use in early menopause.

With all the swings HRT is going through, what’s a menopausal woman to do? Hopefully, women won't become too hot and bothered and lose sleep over their decision to use HRT for some sought after relief.


Stefanie said...

Finding people who support the use of HRT (other than docs) would be really helpful to me as I am about to start. Any idea where to find more blogs of this sort with opinions from women?

Julia A. said...

I'm not interested in HRT, but in BHRT. Premarin is manufacturered from pregnant horse urine, and I'm NOT interested in having that in my body! Bio-identical ("natural") Hormone Replacement Therapy on the hand interests me a great deal. There are several doctors in Hattiesburg I know of who use this. My mom goes to Dr. Rebecca Boyd; another one is Dr. Nancy Weible. Good luck to you!