Safety of hormone replacement therapy revisited

Many women may benefit from HRT


When Sasha Parker was nearing menopause, she began to feel the typical symptoms as her hormones changed.

As hard as it was to deal with the hot flashes and the night sweats, she was more fearful of hormone replacement therapy after a major study concluded HRT was dangerous.

"Something that kept me from absolutely not wanting to do it," Parker said.

The government study, part of the $1 billion Women's Health Initiative was halted in 2002, all amid concerns that HRT did increase a woman's risk for heart disease, stroke and breast cancer.

"The previous message was, everybody stop using hormones, and the doctors are afraid of getting sued, patients are obviously getting more and more breast cancer so they're paranoid about that," Dr. Jabal Uffleman, a South Florida OB/GYN said.

It now appears that paranoia may have been unfounded.

"Further review of the study revealed that the reason that there was increased heart attacks in these women was because they were starting at age 63 on estrogen," Dr. Emilio Juncosa, a South Florida OB/GYN said. "And in real life, you don't start people on estrogen at 63, we usually start them at 50 when they're having significant hot flashes."

In fact, further studies show that HRT may actually offer protection against heart disease in healthy patients.

"I reassure my patients, currently, that using estrogen for a short time at the time of menopause is essentially safe," Dr. Juncosa said.

Along with oral medications, Parker gets injected with testosterone pellets on a regular basis.

"You want to make sure that you're safe, but you want to feel good, you want to be able to age positively," she said.

She's among a growing number of women who would like to stay on hormone replacement therapy for years.

"I think that's okay if they're starting in their late 40's, early 50's, they're not smokers, have hypertension or diabetes," Dr. Uffleman said. "You can imagine their vessels are probably healthy therefore the hormones aren't going to be as dangerous."