Hormone therapy risks may fade over long-term

Wednesday April 6th, 2011

Stroke risk from oestrogen therapy seems to disappear over the long-term, researchers said last night.

The findings may cast new light on the concerns that have led to women abandoning wide-spread use of hormone replacement therapy.

In the Women's Health Initiative study, postmenopausal women who had had a hysterectomy were given oestrogen therapy. It was so closely linked to increased stroke risk that the study was stopped a year early, after about seven years since the end of treatment.

But now the same participants have been studied about ten and a half years since treatment. Participants had been on oestrogen therapy for about six years.

Dr Andrea LaCroix of the Fred Hutchinson Cancer Research Centre, Seattle, USA, and colleagues. report the raised risk of stroke had dropped. The protection against hip fracture had gone, and the reduced risk of breast cancer was maintained. Full details appear in the Journal of the American Medical Association.

The authors explain: "The Women's Health Initiative Estrogen-Alone Trial was a double-blind, placebo-controlled, randomised clinical trial evaluating the effects of conjugated equine oestrogens on chronic disease incidence among postmenopausal women with prior hysterectomy."

They recommend that this group of women should be advised on the increased risks linked to treatment with conjugated equine oestrogens. "Our results emphasise the need to counsel women about hormone therapy differently depending on their age and hysterectomy status," they conclude.

In an editorial, Dr Emily Jungheim and colleagues at the Washington University School of Medicine, USA, say there may still be a role for short-term use of this treatment.

They add: "but this role may be vanishing as existing and emerging data continue to be better understood in terms of application to patients".

LaCroix, A. Z. et al. Health Outcomes After Stopping Conjugated Equine Estrogens Among Postmenopausal Women With Prior Hysterectomy: A Randomized Controlled Trial. The Journal of the American Medical Association, Vol. 305, April 6, 2011, pp. 1305-14.

Jungheim, E. S. and Colditz, G. A. Short-term Use of Unopposed Estrogen: A Balance of Inferred Risks and Benefits. The Journal of the American Medical Association, Vol. 305, April 6, 2011, pp. 1354-55.

Tags: Geriatric Health | North America | Pharmaceuticals | Women’s Health & Gynaecology

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