Hormone Therapy Questioned in Some Cases

Symptoms of menopause return in about half of women who stop taking hormone therapy, according to a new study in this week's Journal of the American Medical Association. Hormone therapy is still prescribed for women with severe symptoms, but doctors recommend brief courses of treatment.

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Millions of women stopped taking hormone therapy for menopause three years ago after a landmark study was released. It showed hormones raise the risk of heart disease and certain cancers. Little has been known scientifically about what happened to these women until now. A study in this week's Journal of the American Medical Association shows that many women started having menopausal symptoms again, even after years of hormone therapy. NPR's Patricia Neighmond reports.

PATRICIA NEIGHMOND reporting:

Judith Ockene and colleagues surveyed over 8,400 women who were part of a large study looking at the benefits and risks of hormone therapy. About half were on hormone therapy; half were not. Those on the medication stopped taking it after the announcement about risk. Ockene is a psychologist at the University of Massachusetts Medical School.

Dr. JUDITH OCKENE (University of Massachusetts Medical School): The findings from this study indicate that a large percentage of women who use a combination estrogen plus progestin are likely when they stop to find that the symptoms return, even after an average of 5.7 years of use.

NEIGHMOND: More than half of the women who suffered severe symptoms when they entered the study experienced a resurgence.

Dr. OCKENE: We're talking about the very common symptoms that are sort of often the most troublesome to women: hot flashes and night sweats, joint pain and stiffness, general aches and pains, low back pain and neck pain.

NEIGHMOND: Along with difficulty sleeping. Ockene says it may be that women simply can't escape the trials of menopause.

Dr. OCKENE: It may be that women do need to go through some level of allowing their body to sort of adjust to decreasing levels of estrogen in the body. They can't merely just leapfrog over this or eradicate these problems, but that they may merely just alleviate them for a while.

NEIGHMOND: But there are many questions about menopause yet to be answered. Epidemiologist Diana Pettiti works for Kaiser Permanente and wrote an editorial in the same issue.

Dr. DIANA PETTITI (Kaiser Permanente): Which symptoms that are attributed to the menopause are indeed symptoms that are due to ovarian failure, and which symptoms are symptoms that are due to simple aging, and which symptoms may be due to the expectation that one is going to have symptoms?

NEIGHMOND: Future research will look into these questions. Meanwhile, psychologist Ockene is starting another study to look at potential benefits of alternative treatments for menopausal symptoms. In the current survey, about one in five women said they tried an alternative treatment--everything from drinking more fluids, exercising more and changing their diet to acupuncture and massage. Nearly 90 percent reported the treatments helped. Dr. Pettiti says the findings of this study should make decisions about whether to take hormone therapy easier.

Dr. PETTITI: It suggests that if you have bad symptoms now, you probably will have symptoms when you withdraw, but that those symptoms will be manageable through a variety of other alternative therapies, and I think it also suggests that women who are contemplating the use of hormone therapy for these symptoms might try something else first. They might try one or two things first to see if it works for them.

NEIGHMOND: But even if it does, it's still not clear how long women might have to use alternative treatments. Doctors still don't know for sure how long symptoms of menopause actually last. Patricia Neighmond, NPR News.

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