Hormone replacement therapies slowly making a comeback

Should women who suffer from the demobilizing symptoms of menopause hot flashes, night sweats, sleeplessness and mood swings take hormone replacement therapy?

That is the question facing many women, since a groundbreaking study a decade ago turned the tables on the medical approach to relieving the symptoms of menopause with hormones.

The answer: the decision is a highly individualized one, to be determined between each patient and her doctor, South Florida physicians say.

There is not one answer that fits all women because each womans risk is different, said Dr. Silvina Levis, professor of medicine at the University of Miami Miller School of Medicine and director of its Osteoporosis Center.

In 2002, a study by the Womens Health Initiative was halted after 5 years when researchers found that estrogen and progestin supplements significantly increased the rate of heart attacks, stroke, blood clots and breast cancer in healthy postmenopausal women.

The increased risk of a heart attack or stroke began in the first year of hormone use, while the risk of breast cancer jumped after four years on hormones.

While the studys methodology has been criticized by many, there is no doubt that the conclusions have caused a sea change in how doctors prescribe hormones to their patients, physicians say.

Until then, the prevailing medical belief was that hormone replacement could help prevent such ailments as heart disease and osteoporosis. Women often began taking hormones as soon as they began feeling the symptoms of menopause, and continued them for life.

Now, doctors suggest that women in perimenopause (the period before menopause begins) or menopause, who are suffering from symptoms that are interfering with their daily lives, should consult with their doctor if they wish to consider hormone replacement.

What changed is the practice what women choose to do and what doctors prescribe, it changed it significantly, Levis said. Now, the pendulum is swinging back a little bit, in that some women do get estrogen.

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Hormone replacement therapies slowly making a comeback