Hormone risk overstated

CHICAGO – Maybe hormones aren’t so bad for women’s hearts after all – if the women are still in their 50s.

In a postscript to a landmark study five years ago that led millions of women to abandon hormones during menopause, a new review suggests the heart risks for this group of women were overstated.

In fact, hormones probably are a reasonable short-term option for women in their 50s who need relief from hot flashes, night sweats and other symptoms, said Dr. Jacques Rossouw, the government researcher who led the original research and the new review of the high-profile Women’s Health Initiative.

The pills – either estrogen alone or a combination of estrogen-progestin – don’t get a complete stamp of approval because of stroke risks for both and breast cancer risks for the combination pill.

The new analysis indicates the pills don’t raise the risk of heart attack for women in the 50-to-59 age group. However, that age group did see a higher risk of breast cancer from the combination hormone and a higher risk for stroke from that pill and estrogen alone.

The risk was even greater for older women. That’s because women in their 70s or who are 20 years past menopause already face increased heart, stroke and cancer risks by virtue of age alone.

Dr. Deborah Grady, a researcher at the University of California at San Francisco, said many women and doctors overreacted to the initial study data and the reanalysis may help temper some of the aversion to hormones that followed.

“Hormone therapy in women who are near menopause is probably not very dangerous,” Grady said.

However, concerns remain about the higher risk for breast cancer, which turned up in the original study of estrogen-progestin pills. So the general advice for hormones remains the same: Use them only to relieve symptoms, at the lowest effective dose for the shortest possible time, Rossouw said.

The report is in today’s Journal of the American Medical Association.