Good news
Studies that once had many women fleeing from hormone therapy are being re-examined, unearthing some surprisingly good news. It looks as though reinvented HT will be better, safer and won’t put you in the position of trading sleepless nights, hot flashes and weight gain for breast cancer and heart disease.
Bringing sexy back
JoAnn Manson, author of Hot Flashes, Hormones & Your Health, was a principal investigator of the massive Women’s Health Initiative (WHI) study, which, in 2002, scared many women off HT when part of the study was halted due to an increase in breast cancer and heart disease risk among some groups of the participants on HT. Last year, Manson helped lead a new investigation of the original data and found that while women on HT who were 10 years or more past menopause had a higher risk for heart disease, it had the opposite effect on younger, recently menopausal women. For example, the younger women were 60 per cent less likely to have significant calcified plaque buildup in their arteries — a precursor to heart attacks— than their counterparts on placebos.
“All the research attention is now focused on this timing hypothesis,” says Judith Turgeon, an endocrinology professor and an HT researcher at the University of California, Davis. “While you’re recently menopausal, starting estrogen therapy may decrease your vulnerability to some diseases before it becomes advanced. If you start the therapy after this critical window, estrogen can have the opposite effect.” Turgeon points out that researchers are still trying to figure out the length of this window of time.
According to this earlier-is-better hypothesis, the key is to start estrogen therapy while your body is still receptive to the hormone. Studies at the University of Washington, for instance, found that certain estrogen receptors in the brain effectively shut down after withdrawal from estrogen, opening the door to higher risk of neurological damage from stroke — something that early treatment with estrogen and it’s anti-inflammatory effects prevented. Now two high-profile studies are putting this timing hypothesis to the test: the Kronos Early Estrogen Prevention Study (KEEPS), which will follow 720 recently menopausal women, and the Early Versus Late Intervention Trial With Estradiol (ELITE), which involves more than 500 women. Preliminary results from both studies are expected in 2009.
Timing is everything
“In the WHI study, older women were given high and continual doses of hormones,” says Hugh Taylor, director of the Yale Menopause Program and one of the lead investigators in the KEEPS trial. “Now we’re testing low doses, and finding we can get away with administering lower doses of estrogen and using progesterone for only part of the month or even less than monthly, while still maintaining the same benefits,” he says. “We time the dosage like a woman’s monthly cycle.” Taylor’s research suggests that after a year, even these low doses are still high enough to keep a woman’s endometrial cancer risk in check and may be low enough not to hike her risk for breast cancer.
This article originally appeared in the April 2008 issue of More
