Hormone-therapy study finds risks outweigh benefits

By Robbie Dingeman
Advertiser Health Writer

The National Institutes of Health is ending a hormone-replacement study that includes 145 Hawai'i women because the health risks appear to outweigh the benefits.

The announcement, scheduled for today, follows NIH decisions in 2002 and 2003 to discontinue similar studies and deals another blow to research on hormone replacement therapy, or HRT, the medication taken by millions of American women for relief of menopausal symptoms and prevention of health problems. The studies challenged the conventional wisdom imparted for nearly 60 years by most obstetrician/gynecologists on HRT.

Today's action involves a nationwide study of 11,000 women on the effects of taking estrogen. The NIH said it is cutting short the eight-year study by a year because the data so far indicate an increased risk of stroke among participants. The data also show no effect on the number of women who develop heart disease, a key question of the study.

Notification letters have been sent to 145 women in Hawai'i, said Dr. J. David Curb, principal investigator of the Women's Health Initiative study in Hawai'i. The letters tell the women, who are between 50 and 79, to stop taking their daily dose of estrogen or placebo, said Curb, president, chief executive officer and medical director of Pacific Health Research Institute.

The early results of the study also indicated estrogen decreased the risk of hip fracture. A hormone replacement therapy using estrogen alone is prescribed for women who have had hysterectomies.

Curb said today's action has implications for women who routinely relied on hormone replacement therapy and now question its safety and effectiveness, Curb said.

Curb said women should talk to their doctors about the risks and benefits of taking hormones.

Hormone replacement therapy gained popularity as a way to reduce the hot flashes, night sweats, sleeplessness, vaginal dryness and other symptoms that sometimes accompany menopause.

But in July 2002 the NIH stopped one study group of women from taking a combination of estrogen and progestin three years early because researchers determined there was an increased risk for breast cancer, heart attacks, blood clots and strokes, outweighing the apparent protection offered against osteoporosis and colorectal cancer.

Last year, the NIH discontinued the remaining estrogen/progestin study group after data revealed an increased risk of dementia.

The Women's Health Initiative is 15-year research program designed to address heart disease, cancer, and osteoporosis — the leading causes of death, disability and injury in postmenopausal women.

Curb said women who do need estrogen can consider using them in low doses for shorter time periods.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.