| |
THE ASSOCIATED PRESS, March 2, 2004
The government is ending the last major study of estrogen,
saying taking estrogen alone isn't as bad as taking it together
with the hormone progestin, but it's still too risky for long-term
use.
Women who took estrogen alone after menopause had a significantly
increased risk of stroke, and possibly a higher risk of dementia
too, the National Institutes of Health said.
Doctors long thought
that using estrogen, alone or together with progestin, would
keep women healthier after menopause, in such ways as reducing
heart attacks and keeping the brain sharp.
Millions of women
have quit using the estrogen-progestin combination since 2002,
when federal scientists warned that those pills raised the
risk of breast cancer, strokes and heart attacks.
Scientists
weren't sure whether estrogen alone was as risky. Only women
who have undergone a hysterectomy can even consider taking
estrogen alone; in other women, progestin use with estrogen
is crucial to protect against uterine cancer. Now, the NIH
is shutting down its study of estrogen-only use, too, telling
the 11,000 women enrolled to quit their pills, essentially
ending hope that estrogen alone would have some overarching
usefulness that the hormone combination didn't.
The women,
who were healthy 50- to 79-year-olds, took either estrogen
or a dummy pill for nearly seven years. Among the findings
released Tuesday:
* Estrogen alone increased the risk of a
stroke as much as estrogen-progestin does. For every 10,000
women, those taking hormones suffer eight more strokes per
year than nonhormone users.
*
Estrogen alone had no effect,
good or bad, on heart disease. In contrast, the estrogen-progestin
combination increases heart attack risk by 29 percent.
* Estrogen
alone didn't increase the risk of breast cancer. Again in contrast,
the estrogen-progestin combination had increased that risk,
by 26 percent.
Neither type of hormone therapy seems good for
women's brains. Preliminary data from a related study of women
65 and older suggest those taking estrogen alone were more
likely to suffer some degree of dementia than those taking
a placebo, the NIH said.
Likewise, scientists announced last
May that the estrogen-progestin combination doubled the risk
of Alzheimer's and other forms of dementia.
Both estrogen alone
and with progestin have some benefits. Both types decrease
the risk of a hip fracture from bone-thinning osteoporosis,
and are the more effective treatment for such symptoms of menopause
as hot flashes.
But the NIH said considering the pills' other
risks, only women who cannot take one of the nation's many
other osteoporosis treatments should consider estrogen for
that use. The Food and Drug Administration stresses that women
who use any form of estrogen to relieve menopausal symptoms
should use the lowest dose for the shortest duration.
Women
now taking hormone therapy, or considering it, for those two
reasons must discuss their individual risk factors with their
doctors, cautioned the American Society for Reproductive Medicine.
The NIH decided to stop the estrogen-only study last month,
a year before its planned completion, saying enough data had
been collected to assess overall risks and benefits. The agency
plans to report details of the data within two months, but
released preliminary findings Tuesday to coincide with letters
telling study participants to quit their pills.
Copyright © 2004, Newsday,
Inc.
|
Menopause