Mary Manning
New Guidelines on Hormone Replacement Therapy from the FDA
On Tuesday, September 9, 2003, the U.S. Food and Drug Administration (FDA) unveiled a new Web site with information on hormone replacement therapy: www.fda.gov/womens/menopause
It explains how to weigh the risks and benefits of both the estrogen-progestin combination and estrogen alone, an option only for women who have had hysterectomies. The site includes a fact sheet and a pocket guide (in English and in Spanish) both of which can be printed out and taken to the doctor when discussing treatment for the symptoms of menopause.
Last year, a major study concluded that long-term use of the hormones estrogen and progestin significantly increase a woman's risk of heart attack or stroke beginning in the first year of use, and an increased risk of breast cancer after four years of use. However, hormone therapy is considered the most effective treatment for menopausal symptoms of hot flashes, night sweats and vaginal dryness. It is also beneficial in reducing the risk of bone-thinning osteoporosis. Women who choose hormone therapy to treat these symptoms should use the lowest dose that helps for the shortest amount of time.
The key points of the new recommendations are:
- Hormones should not be taken in hopes that it will protect you from heart attacks. The pills can actually harm the hearts of previously healthy women.
- If you are using HRT to prevent osteoporosis, you should consider taking some other medications that have not been shown to increase the risk for breast cancer, such as raloxifene.
- Women who have found relief from severe hot flashes with HRT but want to stop, should do so slowly over time-possibly as long as 6 months. By stopping the supplements abruptly, the hot flashes may return severely.
- For the women who use estrogen alone - a therapy restricted to those who have had hysterectomies because estrogen causes uterine cancer unless balanced by progestin - these warnings do not apply. The National Institutes of Health (NIH) is continuing a study of those women, considering the risks and benefits to be still unclear.
- The NIH urges women taking hormones to speak with their doctors about what to do.
For more information:
National Women's Health Information Center
US Department of Health and Human Services
www.4woman.gov
National Institutes of Health (NIH)
www.nih.gov/PHTindex.htm
