In a related matter, a new study has provided more information relating to hormones. Among the many unanswered questions about hormones prescribed for menopause is whether a woman’s health risks change after she stops taking the pills. This study shows that virtually all the benefits disappear but that a slightly higher risk for breast and other cancers persists for at least three years after stopping the drugs. The data come from a major study by the Women’s Health Initiative that looked at 16,000 women who used the estrogen and progestin combination drug Prempro, made by Wyeth.

Reporting in the current Journal of the American Medical Association, the study’s investigators urge caution in interpreting the results, noting that a woman’s individual risk remains small. The excess cancer risk among former hormone users translates to an added annual risk of 0.3% for an individual woman, or three additional cases of breast or other cancers a year among 1,000 women. The findings do not change recommendations for hormone use, which advise that women consider using hormones only if they have moderate to severe hot flashes and other symptoms, and only at the lowest dose and for the shortest possible time. Dr. Gerardo Heiss, the report’s lead author and a professor of epidemiology from the University of North Carolina, Chapel Hill, observed:

What we found in the study is quite consistent with the current guidelines. There is no reason for alarm. The absolute risk is of small magnitude.

One of the biggest benefits of hormone drugs, an improvement in bone health, all but disappears during the three years after women stopped taking the drugs. But risks like blood clots, stroke, and heart attacks originally seen among older hormone users in the study also quickly dropped back to normal rates once women stopped the drugs. The research was halted in mid-2002 because older women in the study were at higher risk for heart attacks if they began using hormones. It appears that the findings have changed the medical community’s views on hormone therapy, which was once used as a treatment to prevent chronic disease. Currently, menopause hormones are advised only for the treatment of moderate to severe hot flashes and other menopause symptoms, and doctors typically prescribe far lower doses of the drugs than those used in the study. The report focuses on the three years after the end of the study, comparing the health of women who took hormones with that of participants who took placebos.

It was reported that future papers will analyze cancer trends in the study. During the three years women stopped taking hormones, there was some suggestion that their breast cancer risk began to drop from peak levels, but the overall risk remained the same. The breast cancer data were said not to be statistically significant, suggesting chance could play a role. However, researchers say the trends are credible because they are consistent with previous research. Other data on cancer risk also failed to reach statistical significance. For instance, there was a suggestion that lung cancer risk was slightly higher among former hormone users, but that trend could also be due to chance. It was only after researchers combined all the data from various types of cancers that they were able to show a statistically significant difference between the former hormone users and those who had used placebos. It will be most interesting to see what develops in the medical community as a result of this study.

Source: Associated Press

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