KELLY MCEVERS, HOST:
For years, studies have gone back and forth about how beneficial hormone replacement therapy is for keeping women healthy after menopause. NPR's Rae Ellen Bichell reports a study out today suggests the timing of the treatment could make the difference.
RAE ELLEN BICHELL, BYLINE: For years, when women went through menopause, doctors told them they should take hormones known as HRT to alleviate hot flashes, like the medication advertised in this 2002 TV ad, featuring singer Patti Labelle.
(SOUNDBITE OF ARCHIVED RECORDING)
PATTI LABELLE: I said yes to HRT. Now, my hot flashes are gone. I feel great.
BICHELL: Doctors also told women that hormones could do a lot more than that - they could prevent heart attacks, broken bones, even protect from colon cancer - so women would stay on them for years. But then, a bombshell hit. A big federal research project said, wait a minute, hormones aren't wonder drugs after all, and they could actually be dangerous, putting women at a higher risk of heart disease, stroke and breast cancer.
HOWARD HODIS: It's scary, right? I mean, no woman wants breast cancer. No human wants cancer, period.
BICHELL: That's Dr. Howard Hodis, a professor of preventive medicine at the University of Southern California. But for years, researchers like Hodis have wondered whether hormones could still help some women reduce the risk of heart disease. The idea is that estrogen might reduce the risk for heart attack by preventing women's arteries from getting clogged, like keeping pipes from getting rusty, especially if they started treatment early enough.
HODIS: If you start somebody that's already got rusty pipes and put them on therapy, it doesn't do much. We said, look, we think there's a timing issue here.
BICHELL: Past studies might have started treatment when it was already too late, like trying to clean pipes that have already started to rust. So they launched a study involving almost 650 post-menopausal women. The researchers tested the effect of starting estrogen sooner after menopause - within six years. They used ultrasound to periodically check how think the walls of participants' blood vessels were.
HODIS: If we had clean vessels, let's say, and you start hormone therapy, you can slow down and somewhat prevent the accumulation of rust, right, the hardening of the arteries.
BICHELL: They report what they found in this week's issue of the New England Journal of Medicine. The artery walls of women who took estrogen thickened more slowly, but the effect only worked if they started taking the hormone soon after menopause. By comparison, women who waited to start taking the hormone until 10 or more years after menopause didn't experience a benefit. Dr. Caren Solomon is a women's health physician at Brigham and Women's Hospital in Boston.
CAREN SOLOMON: That's biologically a really interesting observation because it suggests that beneficial effects of estrogen may depend on timing.
BICHELL: But the study still hasn't proven this actually translates into less heart disease.
SOLOMON: The clinical implications of this finding are very unclear.
BICHELL: First off, she says, just because a person has thinker vessels doesn't necessarily mean she's going to actually have a heart attack. And a study would need to be a lot bigger...
SOLOMON: Yeah, many thousand.
BICHELL: ...And follow women for a lot longer to make conclusions that would be relevant to actual patients. So Solomon says, no one should start taking estrogen long-term to avoid a heart attack. Current recommendations still hold. Women should only take hormones to alleviate hot flashes and other symptoms of menopause - the smallest dose for the shortest time possible. Rae Ellen Bichell, NPR News.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.