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Estrogen therapy: the pros and cons
Hormone replacement therapy has been found effective at treating some of the symptoms of menopause, but experts continue to debate the downsides.
By Robert Bazell
Sept. 12 - Seventeen million American women take medication to replace estrogen that declines in midlife. Yet while the drugs have been on the market for 60 years, information about the risks and benefits has been changing so fast that even some doctors are overwhelmed.
"I THINK it's been a very trying time for the practitioner," said Dr. Elizabeth Barrett-Connor, a professor of epidemiology at the University of California, San Diego, one of the top experts in the field. "I think we're at a very elementary stage of how to prescribe estrogen." But some patients wonder how the science of the hormone estrogen can still be at an elementary stage 60 years into the game. "Yes. It is interesting. But I ... do think we've made a lot of progress," she said, adding that new studies are revealing more and more details about the risks and benefits.
There is no question hormone replacement effectively treats hot flashes, mood swings and other symptoms of menopause. It also lessens the bone thinning of osteoporosis. But no one knows if it cuts the number of hip fractures - the biggest danger of osteoporosis. While doctors once thought estrogen reduced the risk of heart disease, some research now shows it may not. And there is strong evidence suggesting the hormones may increase the risk of breast cancer. Looking at all the information, some, like Constance Spahn, opt for the medication. "I felt that it was worth the risk to feel good," Spahn said. Others, like Alice Stamm, think the treatment is not just wrong but dangerous.
"I think doctors take too many risks with women and women's health," Stamm said.
Hormone Replacement Therapy
Here's what researchers have to say about the advantages and disadvantages of HRT.
Pros
Cons
opening a new era of medicine where both patients and doctors know there is no right answer and today's answer might be different tomorrow. "I think both the doctor and the woman need to realize that every woman is different. This isn't a cookie-cutter business," Barrett-Connor said.
And with more new studies due in the next few years, hormone replacement is likely to become even more complicated
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