Fitness Club

Once again, a research study has turned up damning evidence against the hormone replacement therapy that millions of women continue to use to ease the symptoms of menopause. In brief, women who took estrogen plus progesterone for five years or more were more likely to get breast cancer; they were also more likely to get other, more serious, cancers; and they were at greater risk of dying from them.

These were the main findings of a study published this week in the Journal of the American Medical Association.

The conclusions are based on 11 years of follow-up with more than 12,000 participants in the Women's Health Initiative study, which found in 2002 that prolonged use of HRT increased the incidence of ovarian cancer, breast cancer and strokes, among other ill effects.

The study was halted when those findings came to light, and all participants stopped taking hormones; however, researchers continued to monitor the participants.

The most recent study contradicts earlier studies that concluded the increased risk connected with HRT applied only to less aggressive, more treatable tumors that some doctors considered no more than minor problems. For the first time, researchers found a link between hormone therapy and increased risk of death.

Guessing Game

All categories of breast cancer were increased among women who used HRT, and as a group, their cancers were more advanced. Twice as many of them died versus WHI participants who took a placebo instead of HRT.

Rowan Chlebowski, MD, of the Los Angeles Biomedical Research Institute, who authored the most recent analysis, has said that even though the risk of death is low -- 2.6 per 10,000 per year -- it is real.

HRT sales plummeted following the 2002 report, but doctors continue to prescribe it to millions of women, betting that lower doses taken for shorter periods of time won't be harmful to their patients. However, there is no research to support the validity of that approach.

To Die For?

Hormone replacement therapy for the treatment of menopausal symptoms seemed like one of the wonders of the modern world when it first became available. For some women, those symptoms can be severe -- even disabling.

Yet no woman has ever died from menopause. OPINION Doctors need to free themselves from the influence of big pharma and the pressures applied by patients who want a pill to cure whatever ails them -- even if it means rolling the dice.

The percentage of women who die as a consequence of seeking relief from menopausal symptoms may be tiny, but for those who represent that small slice of humanity, the consequences are significant indeed.

No drug should be prescribed merely to relieve pain or discomfort if death could be the result -- except to patients who are already terminally ill or whose lives really aren't worth living without it.

Few cases of menopausal distress would meet that standard.