| Newsletter Winter 2003
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Hormone Replacement Therapy: The New Dilemma
On July 9, 2002 the National Institute of Health halted a hormone replacement therapy (HRT) study that was examining the long-term effect of  certain hormones on women’s health. Researchers concluded that the risks for the study group outweighed the benefits. The sudden cessation of the program created a sense of alarm and confusion for thousands of women taking hormones. Here’s a look at why the study was stopped, and the implications on women’s health.
The National Institutes of Health (NIH) established the Women's Health Initiative (WHI) in 1991 to address the most common causes of death, disability and impaired quality of life in postmenopausal women. It was one of the largest U.S. prevention studies of its kind.
The HRT trial involved the hormones estrogen coupled with progestin for the prevention of heart disease and hip fractures, while monitoring for possible increases in risk for breast and colon cancer. Before this study began, it was well-documented that the use of estrogen alone promoted cancer of the uterus, an effect that could be countered by adding progestin to the mix. This mix resulted in HRT, the marriage of estrogen and progestin.
“The Women’s Health Initiative has two arms to the study,” says Obstetrics/Gynecology
physician Philip Mead, MD. “One arm looked at women who were menopausal who had a uterus. They were on Premproâ. Prempro has a combination of estrogen and progestin. The other arm of the study looked at women who had had a hysterectomy, and they were given Premarinâ. This drug doesn’t have the progestin hormone.”
The Premarin study is still underway, with no red flags so far. The HRT study was halted because, while there was no difference in the death rates between the group on HRT and the placebo group, there was a small but significant risk for heart disease, breast cancer, stroke and blood clots for the women on HRT.
A Look At the Risks
The risk for heart disease was 29 percent higher for the group taking HRT than for those on placebo. On the average, there were seven more cases of heart disease events (such as non-fatal heart attack) per 10,000 women per year. The risk appeared in the first year of HRT.
Breast cancer was 26 percent higher in th
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