JAMA Weighs in on HRT

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The Journal of the American Medical Association has published results from the ongoing Women’s Health Initiative, the 2002 study that rocked the world of menopausal women by determining that hormone replacement therapy (HRT) increased a woman’s risk for breast cancer.

The current study uses follow up data of 80% of the women in the original study over the course of 6-8 years.  The women were either give a combination of estrogen and progesterone or a placebo.  For every 10,000 women, the combo group reported:

  • 6 additional cases of heart problems
  • 9 more strokes
  • 9 more cases of breast cancer
  • 6 fewer cases of colorectal cancer
  • 1 fewer case of uterine cancer
  • 6 fewer hip fractures
  • 1 less death

The effects of HRT wore off once the course of treatment stopped; however, breast cancer risk remained slightly elevated.

Age was a definite factor — the lowest risk was among women aged 50-59, while the highest was in those from 70-79.

In the early days of HRT, the medical community believed that the estrogen part of the HRT equation reduced heart disease; but this current study reveals that heart disease is increased by synthetic HRT.

Additionally, researchers in 2002 believed that although breast cancer risk increased with HRT, the type of breast cancer that HRT affected was an easier, less dangerous form of the disease.  However, a 2010 study disproved this assertion — at that time JAMA reported that women who were on HRT were two times more likely to die from breast cancer than those given a placebo.

The original Women’s Health Initiative study led to a decrease in HRT; as a result breast cancer in older women dropped sharply.

Despite the results of the current study, the research team announced that HRT is “appropriate for symptom management in some women,” but only temporarily.  Prior to the 2002 study, some women were on HRT for life, which isn’t even a consideration currently.

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