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The Case Against HRT
Studies Show Hormone Therapy May Do More Harm than Good
Estrogen-Progestin Study
About 6 million U.S. women take estrogen-progestin hormone therapy. The NIH's National Heart, Lung and Blood Institute called a premature halt to a major study of that therapy, saying results show an associated increase in health risks.
Participants: 16,608 women between the ages of 50 and 79.
The Drug: A combination of two hormones, estrogen and progestin, marketed as Prempro.
The Method: Eight-thousand women, randomly selected, were given a placebo. The remaining 8,000 in the study were given the hormone combination.
The Findings: The hormones produced harmful effects that outweighed the drug's benefits.
The Risks: Among women taking the hormones, there was an increased risk of breast cancer, heart disease, stroke and life-threatening blood clots.
The Benefits: Fewer hip fractures and fewer cases of colorectal cancer. (Among 10,000 women taking the drug, there would be six fewer colorectal cancers and five fewer hip fractures.)
The Numbers: If 10,000 postmenopausal women take estrogen-progestin, in 1 year, compared with a control group, they would experience the following:
• Seven extra cases of heart disease.
• Eight extra cases of breast cancer.
• Eight extra cases of stroke.
• 18 extra cases of blood clots.
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August 2002 -- Part of one of the largest clinical studies ever mounted, the Women's Health Initiative trial showed that women taking a combination of estrogen and progestin hormones, marketed as Prempro, have an increased risk for breast cancer, heart disease and stroke. The study, sponsored by NIH's National Heart, Lung and Blood Institute, did show that women taking the drug had fewer cases of hip fractures and colorectal cancer.
Shortly after that report, another study revealed estrogen-only hormone therapy is also a hazard.
Conducted by the National Cancer Institute and published in the Journal of the American Medical Association, the study tracked the medical histories of 44,000 women over a period of more than 20 years.
Its main finding: Post-menopausal women who used estrogen replacement therapy for 10 or more years were at a significantly higher risk of developing ovarian cancer than women who never used hormone replacement therapy. Women taking estrogen-only pills were 60 percent more likely to develop ovarian cancer than those taking a combination of estrogen and progestin. And those women on estrogen for more than 20 years had a three-fold increase in ovarian cancer.
An estimated 13.5 million women in the United States take hormones during and after menopause to treat its symptoms, such as hot flashes, or to stave off bone-thinning osteoporosis. Nearly 8 million women take estrogen-only drugs; another 6 million use the estrogen-progestin combination.
In Depth
 NPR's Joe Palca reports on the Women's Health Initiative study on estrogen-progestin pills.
NPR's Patricia Neighmond reports on study by the National Cancer of Institute that says
women taking estrogen-only pills are at greater risk for ovarian cancer.
 More NPR stories on hormone therapy.
The trial is part of the NIH's Women's Health Initiative, a multi-faceted research program focused on preventing diseases faced by women as they age. The WHI studies involve more than 40 centers nationwide and 162,000 American women, ages 50-79.
Online Discussion
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