More on Women and Hormone Therapy

Harry Health Guide
  • A new study was published last week and widely reported, as showing that hormone therapy may in fact be good for the heart, in contrast to the result of the Women's Health Initiative released a few years ago, which implied the reverse.

     

    Women have been calling since, and asking if this is true, as well as the broader question of How Can The Fundamental News About Our Health Shift So Radically and So Often?

     

    The short answers to both are: no, it's not true, and the news doesn't actually shift. Fundamental science shifts very slowly over the course of years - but tiny nuances are blown up into major news stories, making it seem as if every day brings a new and conflicting recommendation.

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    The study in question was a study of about a thousand women who had all had hysterectomies.

     

    In that group it seemed that hormone therapy was safe, and associated with a reduction in the build up of calcium in the arteries around the heart. This build up, while still under investigation itself, is accepted as being a reasonable surrogate for the rate of cholesterol build up, and therefore may serve as a long-term indicator of your risk of heart attack or stroke.

     

    There are a number of reasons why this study represents a tiny change in recommendations, if that. The first being that the study was of a very small number of women compared to the 160,000 who were looked at in the parent study. The second is that these are women who all had hysterectomies, and as these become less common over the years, this group of women is less and less representative of the majority of American women. The third is that the study did not follow the women over the long term to look at their actual health, but only at the calcium score, which is only a single, questionable surrogate for long-term heart health.

     

    The short answer to almost all questions about hormone replacement and menopause is that the Women's Health Initiative was a truly massive study which showed with great certainty that hormone therapy has very little health benefit, or risk, over the long haul, but to the extent we can tell, it probably comes down on the side of having a small net risk. If you start having significant symptoms of menopause, hormone therapy works extraordinarily well to relieve those, and you should take it with the confidence that the down-side is very small.

     

    If you don't have symptoms, there is no reason on earth to take the hormones, and certainly no evidence at all that they offer any long-term benefit.

Published On: August 09, 2007