Review on October 20, 2009
From the years of 1995 - 2002 many women turned to hormone replacement therapy in an attempt to find relief from the symptoms brought about by menopause. During these years, the percentage of hormone therapy was on a steady rise until research was conducted revealing the negative side effects caused by such treatments. Women undergoing menopause were urged to lower their doses of hormone therapy and eventually stop using it entirely.
The cause of the steady rise of hormone therapy among women was due to a lack of definitive information concerning the risks and benefits of as well as clever media tactics and smart marketing strategies. The halt in progress came when the Heart and Estrogen/Progestin Replacement Study (HERS) and Women's Health Initiative (WHI) both conducted studies to determine whether or not hormone combination estrogen/progestin use really offered cardiovascular benefits as was suggested.
The outcome of both served to disprove said theory. The HERS testing revealed that post-menopause hormone therapy with combination estrogen/progestin failed to offer any benefit to women with cardiovascular disease. The WHI trial displayed that hormone therapy with an estrogen/progestin combination caused an increased risk of breast cancer and cardiovascular disease in women who have surpassed menopause.
In 2001 hormone therapy patients were tested, finding 14,500 adverse issues attributed to oral estrogen plus progestin. Of the women tested, 3,500 had cardiovascular disease, 2000 had breast cancer, 4000 had strokes and 5000 reported a case of pulmonary embolism.
The databases that performed these surveys were the National Disease and Therapeutic Index (NDTI) database and the National Prescription Audit (NPA) database. The NDTI presented information on patient visits to physicians and associated medication use. Physicians described all diagnoses and indicated newly prescribed and continuing medications used specifically for each diagnosis. The NPA offered data based on the number of hormone therapy prescriptions filled at approximately 20,000 retail pharmacies, independent pharmacies, mail order pharmacies and mass merchandise and discount houses. Data was given for all hormone therapy formulations and individuals brands. These included, oral, transdermal, vaginal applications with combined estrogen/progestin. Both data bases offered information from 1995 to 2003. The findings from both databases were combined to estimate the number of women receiving hormone therapy in the form of estrogen and progestin combination.
The conclusive results combined from both databases showed a significant decline in the use of hormone therapy prescriptions after the publications released by WHI and HERS in July 2002. According to data from July 2003, hormone therapy prescriptions declined by 38 percent.
In 2003, the most recent guidelines recommended against routine hormone therapy use for chronic conditions and that current users taper doses toward discontinuation. If a woman's vasomotor symptoms returned after discontinued use, alternative treatment were to be considered, including lower dose hormone therapy or herbal products.
For women seeking relief from the symptoms of menopause, it was not uncommon that they were prescribed prescriptions containing estrogen and progestin combinations. This trend in hormone therapy was on the rise from 1995-2003 until two studies were conducted and reveal the adverse effects of such therapy. Women who need a solution to menopause symptoms are urged to try less harmful treatment with less side effects. These include natural remedies, exercise and a healthy diet.
- JAMA - The Journal of the American Medical AssociationJAMA. 2004;291:47-53.