Progesterone safe for hot flashes and night sweats, new B.C. study concludes

More than a decade after a bombshell study frightened women off hormone replacement therapy, Canadian researchers say fears over one of those hormones progesterone have been overblown.

A new short-term study by the University of British Columbia and Vancouver Coastal Health suggests that progesterone alone does not appear to increase the risk of heart attack or other diseases of the blood vessels when used for hot flashes and night sweats.

The finding comes 12 years after the landmark Womens Health Initiative Trial reported that a combination regimen of estrogen plus progestin, a synthetic form of progesterone, heightened the risk of heart attack, breast cancer and stroke in women.

Progesterone began to be blamed for heart attack risks, because estrogen was understood to be so good, said Dr. Jerilynn Prior, a professor of endocrinology at the U of B.C. and head of the Centre for Menstrual Cycle and Ovulation Research. That was just the mindset.

Hormone use plummeted. Many women were told to go off hormones and to use fans or face cloths for hot flashes instead.

But when researchers took a second look at the data in 2007 a different picture emerged: the risk of heart disease was higher in women who were 20 or more years past menopause, while younger women (50 to 59), or women who began taking hormones within the first 10 years of menopause, had a lower risk of coronary heart disease.

In 2009, an expert panel of the Society of Obstetricians and Gynaecologists of Canada concluded hormones are a safe option for moderate to severe symptoms if started early and used only over the short-term, meaning four to five years.

Estrogen is currently the main treatment for hot flushes, but Prior is convinced progesterone is a safer alternative. Estrogen, over the longer term, increases the risk for heart attack, Prior said.

Were suggesting progesterone probably doesnt.

As well, the message to women taking estrogen is you cant take it for very long three, maybe four years. But the average duration of hot flushes is more like eight to 10 years, Prior said. So women are caught having to stop the estrogen that helped them and not having an alternative.

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Progesterone safe for hot flashes and night sweats, new B.C. study concludes