Healthy Woman: Hormone Withdrawal Woes

N E W   Y O R K -- Five years ago, hormone therapy was recommended to postmenopausal women almost as a matter of course as a way to protect them from age-related disease and to improve their overall quality of life. How times have changed.

In mid-2002, a major study revealed hormone therapy that combined estrogen and progestin increased heart disease and breast cancer risk and didn't affect well being. Prescriptions for hormone therapy dropped from 90 million to an estimated 57 million within a year.

Then, later data from the study, the so-called Women's Health Initiative, or WHI, showed risk of dementia doubled in women 65 and older who were taking postmenopausal hormone therapy. Prior to this finding, some women were taking hormones, in part, because they were under the impression that it might prevent Alzheimer's disease.

Now, just this week, the estrogen-only phase of the WHI was ended prematurely because not only did it not effect risk of heart disease, but also because it raised the risk of stroke. Even more women are now likely to discontinue hormone therapy.

Yet coming off the hormones is not always easy for women. It's estimated that about a quarter of women who stop hormone therapy resume taking them to ease debilitating withdrawal symptoms such as hot flashes. Quitting is especially difficult for women who have been taking hormones for 10 years or more.

Below, Marcia Stefanick, a professor of medicine at Stanford University and coauthor of a recent study about the national use of hormone therapy, discusses the medical community's latest approach to postmenopausal hormone therapy.

Was the drop in the use of postmenopausal hormone therapy significant?Yes, I think that there was a significant response to new evidence. I think the greatest response from the WHI was specific to combination estrogen/progestin therapy as opposed to estrogen-only therapy. (Estrogen-only therapy is prescribed to women who do not have a uterus.) This was appropriate as the women on estrogen/progestin therapy were the only group that the data related to.