Menopause coincides with the definite cessation of estrogen and progesterone secretion in the ovaries. This phenomenon is at the origin of hot flashes, sleeping problems, advanced onset of osteoporosis and vascular problems. The treatment is called replacement because it replaces the body's waning secretions of hormones and consists at a minimum of taking estrogen complemented with progesterone, in order to imitate the hormone levels that are present prior to menopause.

The objective of the study in question was to evaluate the benefits and risks hormone replacement therapy (HRT) has on menopause over a period of more than eight years on a considerable sample population size. More than 16 600 women between the ages of 59 and 79 actually participated. They received an estro-progesterone composite (estrogen and medroxyprogesterone) or a placebo. This study was part of a clinical trial funded by Women's Health Initiative in order to try to reduce the incidence of breast cancer, heart disease, colon cancer and even bone fractures in menopausal women.

While beneficial in easing menopausal symptoms, HRT presents several side effects such as sensitive breasts, nausea, headaches, and a bloated sensation. However, after a follow-up study period of five years, the authors of the study observed that the risk of stroke increased 41% in women taking the hormones compared with the women in the control group; the risk of breast cancer increased to 26% and heart attacks up to 29%. The number of phlebitis also doubled in the group receiving hormones.

A good reason to think twice about this treatment! At any rate, this trial did not have all but negative results, since hip fractures decreased 23% and colon cancer went down 37%. No change was observed for lung or endometrial cancer.

This data clearly demonstrates that the advantages of HRT are displaced by the risks the women are exposed to while using it. This is the reason why the researchers decided to put an end to the study, which was to be continued until 2005.

These results prove that there is no miracle solution and that all treatments carry some risks. Hormone replacement therapy was seen as a miracle remedy for more than a decade. Even if it was aimed at fighting the short term symptoms of menopause, it was lead to believe that it could have in the long term, protected against osteoporosis, cardio-vascular disease, Alzheimer's and not to mention wrinkles. Doctors gave hormone prescriptions to women in perfect health, solely for preventative reasons.

According to Dr. Lucie Gilbert, from the Royal Victoria Menopause Clinic, doctors still have a tendency to over-prescribe hormone therapy because it is less expensive than other treatments and is covered by medicare.

For the pharmaceutical industry, research and sales of hormones represents a significant economical proportion (Premarin is on the largest selling drugs in Canada).

At present there are more than 3 million post-menopausal women in Canada and by the year 2010, they will make up 33% of the female population. The interest in delaying the aging process and maintaining good health continues to stimulate the market in developing new drugs, including hormone therapy.

These products are heavily promoted and advertised to doctors and consumers. Women who plan to take hormone replacements should take the time to inform themselves and make sure their decision is not influenced by marketing strategies, but is based on valid scientific studies, applied to their situation.

At the Canadian Cancer Society, a committee of experts is reviewing the study. After an examination, they will judge on the validity of the results and submit their recommendations, if need be. "Hormone therapy should be avoided for preventative purposes and should be limited only to women with severe symptoms", advises the Director of Communications, Marie-Claude Lafleur.

References and Sources:

Will taking hormone therapy increase my risk of cancer? Canadian Health Network.
Risks and Benefits of Estrogen Plus Progesterin in Healthy Premenopausal Women. Journal of the American Medical Association (JAMA) 17 July, 2002.
Hormonothérapie pas de panique. La Presse, by Sophie Allard 10/07/2002
The advantages and disadvantages of hormone therapy. Canadian Women's Health Network.
Une histoire d'hormones. La Presse, by André Pratte 01/08/2002
Les dangers de l'hormonothérapie substitutive. Réseau Proteus, by Elisabeth Mercader
Ménaupose et cancer du sein. Hormones or none ? Femiweb.com , Le réseau des parents.