Word: estrogen
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TAKE TWO Just a couple of weeks ago, scientists reported that women using estrogen-replacement therapy for 10 years or more could double their risk of ovarian cancer. Now comes some reassuring news. A preliminary study suggests that combining estrogen with progestin wipes out any increased risk from the estrogen. An estimated 10.5 million American women take estrogen alone--most after they have had a hysterectomy. About 6.5 million are on the combo...
...Carmen Rodriguez, a senior epidemiologist at the American Cancer Society who led the study, is that a woman's chances of dying from ovarian cancer are pretty low--about 1.7% over the course of her lifetime. Twice a low risk is still a low risk. (Study participants who took estrogen actually lived longer than those who didn't--partly because such volunteers often live healthier lives and have better access to medical care...
Next, keep in mind that the J.A.M.A. study was conducted at a time when most doctors still gave women estrogen by itself. Since then, women who haven't undergone a hysterectomy have generally received estrogen plus progestin because the combo reduces the risk of uterine cancer. It's quite possible taking both drugs reduces the risk of ovarian cancer as well...
Clearly, medical researchers are not as confident of the health benefits of long-term hormone therapy as they used to be. Investigators were surprised last year when preliminary evidence from the WHI revealed that taking estrogen with or without progestin slightly increased the risk of blood clots, heart attacks and strokes over a two-year period. The researchers are waiting for the final results to see if the short-term risk is outweighed by any long-term protection for the heart...
Meanwhile, no one is denying that hormone therapy has some pretty powerful short-term benefits. "Estrogen is still the most effective treatment for hot flashes and perimenopausal symptoms," notes Dr. JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital. Nor is there anything in the latest study to suggest that women should avoid taking hormones for a few years around menopause. However, as a practical matter, women who have a family history of ovarian cancer or have undergone a partial hysterectomy (ovaries still intact) may want to rethink their choices for long-term hormone replacement...