Hormone Replacement Therapy

Click Date to read brief description	Click Short Title to read column
02/20/06	Hormones: Does Timing Make a Difference?
03/09/04	Women Continue to Demand Hormones Despite Research
07/16/02	What now? Alternatives to HRT
07/02/02	Reconsidering Hormone Replacement Therapy
03/07/00	Calculating the risks of hormone therapy
02/15/00	The saga of soy. Soy is good food
02/15/00	Estrogen study raises concerns
07/05/99	Sorting out the benefits, risks of HRT
02/16/98	Midlife women finding estrogen alternatives
11/17/97	Alternative to estrogen may get ok
12/16/96	In estrogen replacement therapy, less may be better

After years of frightening findings on hormone therapy, there is finally some reassuring news for women who start taking hormones close to menopause. The new results suggest that there is a “window of opportunity” near menopause during which estrogen therapy may actually reduce heart disease risk, not raise it, as starting hormones a decade or so later seems to do. And this makes good biological sense.

All right, ladies, here we go yet again. About 20 months ago, it was postmenopausal women taking combined estrogen and progestin therapy who panicked at the then-new news that a popular hormone pill, Prempo, carried more risks than benefits overall.

Okay, now what? Last week, a small group of experts set up to monitor emerging results from the massive Women’s Health Initiative, a landmark study on hormone replacement therapy, dropped a bombshell.

I have, once again, become a hormone nibbler. Over the years, I have written extensively – some might even say ad nauseam – about the pros and cons of hormone replacement therapy (HRT) for menopausal women, a subject near and dear to my heart, and to that of every other woman I know over 50

It takes a village, or so they say, to raise a child. Well, it's beginning to take a whole village - and a high-tech one at that - to sort out the risks and benefits of hormone-replacement therapy.

Americans have fallen in love with the humble soybean. Convinced that in its many incarnations - tofu, soy milk, dietary supplements - soy can prevent everything from heart disease to hot flashes to cancer, consumers have sent soy sales soaring. In the 12 months ending in October 1999, supermarket sales of soy foods were up 45 percent over the previous year, to nearly $419 million, according to Spins, a San Francisco market research company.

Americans have fallen in love with the humble soybean. Convinced that in its many incarnations - tofu, soy milk, dietary supplements - soy can prevent everything from heart disease to hot flashes to cancer, consumers have sent soy sales soaring. In the 12 months ending in October 1999, supermarket sales of soy foods were up 45 percent over the previous year, to nearly $419 million, according to Spins, a San Francisco market research company.

It's never been easy sorting out the pros and cons of taking estrogen supplements at menopause. Women have always had to weigh the many benefits -- reduced hot flashes, lower risk of heart disease, osteoporosis, colon cancer, and perhaps Alzheimer's -- against the modest but distressing risks, notably an increased chance of breast cancer and blood clots. But lately, with every new study, it's gotten more complicated.

For the past year, Barbara Lash, a 49-year-old ex-nurse from Franklin, has been determined to fight her hot flashes with anything but the standard prescription drugs like Premarin. On the advice of her nurse practitioner, Lash drinks a soy shake and eats tofu every day. She also nibbles cereal with flax seed, uses herbs like black cohosh and chaste tree berry, takes walks daily and lifts weights when she can.

For more than 50 years now, there has been only one drug around to combat the immediate and longer-term effects of menopause: estrogen. The plusses of estrogen are extraordinary -- reduced hot flashes, less vaginal dryness, lower levels of ``bad'' and higher levels of ``good'' cholesterol, reduced risk of osteoporosis, cardiovascular disease and maybe even Alzheimer's. Not to mention better mood and intellectual function, at least for some women.

Call it coffee klatch research. Or book group medicine. Or just plain winging it. By whatever name, women of a certain age are trying to figure out for themselves -- and with each other -- the answers to a midlife question doctors won't have good answers to for years.