The Hormone Dilemma
The latest flip-flop on hormone therapy gives new hope to younger women
Unfortunately, the new findings don't shed light on what is now the most common use of hormones--lower doses used for a few years around the time of menopause. "The Catch-22 of big studies like WHI is that you're always behind the eight ball," says Wulf Utian, executive director of the North American Menopause Society. "You set out to do the definitive study and use what is state of the art at that time. Then, several years later, you announce the results, but now everyone's using a different combination or dose."
The Kronos Longevity Research Institute in Phoenix is following 720 women to study the effects of lower-dose hormones administered by pill or by patch for shorter periods of time. But that study's results won't be available until 2010.
Despite the new information, some women, like Smith, still feel the risks just aren't worth it. Certainly, no one feels hormones should be used to prevent heart disease. For those women, specific heart medications, as well as diet and exercise, are far safer ways to prevent heart disease. For menopause symptoms, women may want to consider alternatives. A class of antidepressants, selective serotonin reuptake inhibitors, or SSRIs, can help some women with hot flashes and mood swings. Other women have found relief by turning to plant estrogens. "There's some data about increasing the plant estrogens in your diet by eating a lot of soy. It appears to work at least some of the time,"says Richardson. An American Indian herb called black cohosh also seems to ease menopause symptoms for some women. Of course, these alternatives may carry their own side effects, so women should be sure to consult their doctors.
In the end, hormone therapy still seems to be the most effective treatment for severe menopause symptoms. "For some women, I think hormones are worth the risk," says Richardson. "We just have to be honest with them about what we do know and don't know about those risks."For now, at least, it seems the more science knows about those risks, the more complicated the decision becomes.
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