Hormone Replacement Therapy Revisited

Back in the 1990s the federal government launched the Women’s Health Initiative to investigate the health of older women. One of its goals was to determine the risks and benefits of hormone replacement therapy (HRT) in post-menopausal women. The HRT study was stopped early (in 2002) when it was discovered that HRT led to an increased risk of breast cancer, heart attacks, and strokes.

What about the women who were on HRT during the study - do they remain at higher risk even after discontinuing HRT? The good news is that apparently most of the increased risk goes away with time. The first follow-up study indicates that three years after HRT is discontinued, the increased risk of heart attacks disappears, and the increased risk of cancer declines significantly. Future reports will show whether any increased risk of cancer remains as time passes.

Current recommendations for HRT remain unchanged; women should consider HRT only if they have moderate to severe post-menopausal symptoms, and for the shortest time and lowest dose that is effective.

Reference: Heiss, Gerardo, et al. Health Risks and Benefits 3 Years After Stopping Randomized Treatment With Estrogen and Progestin. JAMA 299:1036-1045, Mar. 5, 2008.