A coalition of 14 authoritative groups have just come
together to publish a report on the use of hormone “replacement therapy” in
which they – the groups – decry the apparent apprehension among both physician
and patients to use as much of this HRT as these groups think should be used.
This is all because, they say, there has been way too much
emphasis on that Women’s Health Initiative study from 2002 which found clearly
overall higher risks than benefits to the use of HRT in the population that
that study examined.
And that’s precisely the problem, these groups say,
because (among several reasons that make this study less than exemplary), the
women enrolled in the WHI study don’t really mimic the average women who would
use HRT (the former were much older on average, and had long ago gone through
menopause whereas most women who consider using HRT do so around the time they
pass through menopause or shortly beyond it).
All of which, this report claims, means that so many women
who could benefit from HRT aren’t getting any help, that is, women with
moderate to severe symptoms of menopause for which there is really no effective
therapy aside from hormones.
Bottom line, according to this report: women with such
symptoms should consider the use of HRT, albeit for a “short” time.
The problem with that advice is simple: no one really
knows yet what “short” means when it comes to raising the risk of HRT
complications, especially the serious ones like breast cancer and blood clots.
Is it 6 months? A year? 2 years?
These groups say that the risk of blood clots is “very
low” in women under the age of 60, so that shouldn’t really be a concern.
Yes, but if lots more women were using HRT, we’d
definitely see a spike in blood clots in that age group, especially since it’s
likely that the average weight of menopausal women is rising and obesity (along
with a sedentary lifestyle) is a major risk factor for blood clots.
As well, another recent study found that the longer a
woman takes HRT, the higher her risk of high blood pressure.
Does that risk kick in at 6 months? A year? 2 years? Does
it cause damage even if the HRT is stopped after 6 months?
Who knows?
I’m not sure what I’d do if I were faced with the same
problem but I do know this: for severe symptoms, nothing else works so if a
woman decides to use HRT for symptoms that are overwhelming, she should use the
lowest dose for the least amount of time that she can get away with, not settle
for an arbitrary formula that says HRT should be taken for 2 years or 3 years,
etc.
