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Use of Hormone Therapy Questioned

April 22, 2002|RIDGELY OCHS | NEWSDAY

An international panel has concluded that, based on current evidence, there are questions about using hormone replacement therapy for more than relieving menopausal symptoms such as hot flashes.

Experts gathered by the National Heart, Lung and Blood Institute and Office of Research on Women's Health, both part of the National Institutes of Health, and the Giovanni Lorenzini Medical Science Foundation, a private Italian group, sponsored four conferences over a seven-year period examining the current data on the use of hormone replacement therapy.

Their paper, one chapter of which was presented last month and the rest of which is to be published in June, is "really a synthesis of existing information," said Dr. Jacques Rossouw, acting director of the Women's Health Initiative, a federally funded study. "From my point of view, I don't think there's any new information," said Rossouw, a member of the international panel.

But, he and others said, the purpose of the paper is to help doctors and patients make the best possible decisions.

"Whether or not to go on hormone-replacement therapy remains one of the biggest questions for physicians and women," said Dr. Vivian Pinn, director of the Office of Research on Women's Health.

As recently as five years ago, hormone replacement therapy, or HRT, was recommended to menopausal women for the prevention of cardiovascular disease. But several studies since then have found that it was not protective in older women who already have heart disease. Similarly, studies have found that it does not stop the progress of early Alzheimer's disease. And recent studies have also questioned its usefulness in preventing osteoporosis. Studies have not shown that HRT relieves major depression, although it does appear to help mood and sleep disturbances in women going through menopause. Trials have also found it does not appear to improve urinary incontinence.

Yet hormone replacement therapy remains popular: About 17 million American women take HRT, and Wyeth's Premarin, the most popular HRT drug, is the "No. 1 prescribed product," according to Natalie deVane, a spokeswoman for Wyeth Pharmaceuticals in St. David's, Pa.

The impact of the current paper appeared mixed. Amy Allina of the nonprofit National Women's Health Network praised it, saying "it's not new research, but it's new for NIH to back such a very limited use of HRT, to say it's really only effective in the treatment of menopausal symptoms."

But Dr. Wulf Utian, executive director of the nonprofit North American Menopause Society, said the data are still too preliminary to say HRT has such limited benefit, especially in the prevention of heart disease in healthy women.

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Ridgely Ochs is a staff writer for Newsday, a Tribune company.

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