Nearly two-thirds of women who use hormone supplements to stop menopausal symptoms such as hot flashes, night sweats and depression suffer a recurrence or a worsening of symptoms after they stop the therapy, according to a study published today.
But many of the 63% who had a recurrence were able to alleviate the symptoms with "lifestyle changes, such as drinking more fluids, starting or increasing exercise [and] practicing yoga," said one of the authors, Dr. Jennifer Hays of Houston's Baylor College of Medicine.
The results of the study, published in the Journal of the American Medical Assn., surprised the authors.
"When we first started looking at the effects of hormone supplementation, we had expected to see dramatic improvements in women's health. We haven't found them," Hays said.
In fact, for some women, hormone replacement therapy may be doing more harm than good by triggering a recurrence of symptoms -- a "second menopause," Hays said. About 2 million American women a year go through menopause.
Dr. Diana B. Petitti of Kaiser Permanente Southern California in Pasadena, who wrote an accompanying editorial in the journal, said the recurring symptoms might have been caused by the abrupt cessation of treatment and that tapering off might have allowed women to avoid many problems.
Petitti said the study showed that "we may have seriously overestimated the curative power of hormone therapy."
Hays and her colleagues studied 8,405 women who were part of the Women's Health Initiative, a major study originally designed to demonstrate that hormone replacement with estrogen and progestin therapy reduced the risk of heart disease and stroke.
But when researchers began analyzing the data in 2002, they concluded the therapy actually increased the risk of both diseases, as well as breast cancer.
Those findings prompted the Food and Drug Administration to advise that hormone replacements be taken at the lowest possible dose for no more than five years.
About 14 million U.S. women were taking hormone replacement therapy in 2002. After the results were announced, the number fell to about 11 million.
Most of the women in the latest study stopped taking the hormones when they heard the news. Most were in their 60s and 70s, and had been taking the hormones for an average of about 5 1/2 years.
Hays and her colleagues mailed the women a questionnaire about a year later and found that most had suffered a recurrence of symptoms. The more severe their initial symptoms, the more likely they were to suffer a recurrence.
Surprisingly, some of the women who suffered symptoms when they stopped taking the hormones had no symptoms when they enrolled in the original trial.
For women with recurring symptoms, the most effective treatment was consuming lots of water, Hays said. Exercise and yoga also helped, but no medications proved useful.