Although the risks of hormone replacement therapy (HRT) for women have been debated over the past decade, a coalition of 15 major medical groups have issued a statement saying that it is safe when it’s taken for a short time to fight symptoms of menopause.
In a joint news release, three of the groups – the North American Menopause Society, The Endocrine Society and the American Society for Reproductive Medicine – said that the associations issued the statement because to reassure women and their providers that hormone therapy is “acceptable and relatively safe for healthy, symptomatic, recently postmenopausal women. Over the last 10 years, there has been a complete abandonment of hormone therapy in some settings accompanied by reluctance to treat women who would benefit from relief of their symptoms. As a result, some women have sought unproven alternative therapies. “
The groups’ conclusion came in response to what it called the “highly controversial” Women’s Health Initiative, which concluded that HRT’s risks outweighed its benefits when taken to avoid chronic diseases. The joint statement issued this week dealt with the benefits of HRT when taken to avoid menopausal symptoms like painful intercourse and dry vagina.
“The results of the WHI and the conflicting reports that followed led many women to believe hormone therapy may not be a safe treatment for menopausal symptoms,” said Janet E. Hall, MD, immediate Past President of The Endocrine Society. “We want women to know that there are options out there for relief of their menopausal symptoms. The level of risk depends on the individual, her health history, age, and the number of years since her menopause began.”
According to the statement, points of agreement among the medical groups include:
• Hormone therapy is an acceptable option for the relatively young (up to age 59 or within 10 years of menopause) and healthy women who are bothered by moderate to severe menopausal symptoms. Individualization is key in the decision to use hormone therapy.
• If women have only vaginal dryness or discomfort with intercourse, the preferred treatments are low doses of vaginal estrogen.
• Women who still have a uterus need to take a progestogen (progesterone or a similar product) along with the estrogen to prevent cancer of the uterus. Women who have had their uterus removed can take estrogen alone.
• Both estrogen therapy and estrogen with progestogen therapy increase the risk of blood clots in the legs and lungs, similar to birth control pills, patches, and rings. Although the risks of blood clots and stroke increase with either type of hormone therapy, the risk is rare in women ages 50-59.
• An increased risk in breast cancer is seen with 5 or more years of continuous estrogen with progestogen therapy, possibly earlier. The risk decreases after hormone therapy is stopped.
Besides the The North American Menopause Society, the American Society for Reproductive Medicine, and The Endocrine Society, groups endorsing the conclusions includeAcademy of Women’s Health, the American Academy of Family Physicians, the American Academy of Physician Assistants, the American Association of Clinical Endocrinologists, the American Medical Women’s Association, the Asociación Mexicana para el Estudio del Climaterio, the Association of Reproductive Health Professionals, the National Association of Nurse Practitioners in Women’s Health, the National Osteoporosis Foundation, the Society for the Study of Reproduction, the Society of Obstetricians & Gynaecologists of Canada, and the SIGMA Canadian Menopause Society.
