Word: estrogen
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...picture may not be quite so grim as it seems, however. For one thing, although the study was large--drawing from a pool of 46,355 postmenopausal women--the number of women on combined estrogen and progestin therapy was comparatively modest. For another, the rise in risk only became striking after four or more years of continuous hormone use, which further reduced the pool of subjects. In the end, out of a total of 2,082 cases of breast cancer, 101 occurred among women who were currently taking estrogen-progestin--and of these, a striking 39 occurred among the roughly...
...these reasons, says National Cancer Institute epidemiologist Catherine Schairer, the study's lead author, women should not panic, especially if they are taking estrogen-progestin for just two or three years to obtain relief from the discomfort of hot flashes and mood swings that mark the onset of menopause. Indeed, this study bears out what most experts have long believed: that short-term use of hormones can confer substantial benefits while posing relatively few risks...
Long-term hormone-replacement therapy is a different matter. Unfortunately, what is known at present about the benefits and risks of hormone replacement has largely been drawn from studies of the effects of estrogen taken alone, a therapeutic option that is now reserved for women who have undergone hysterectomies. That's because experience has shown that "unopposed estrogen," as doctors call it, elevates the risk of uterine cancer. By adding progestin to the mix, physicians have found, they can protect the uterus from malignant growth. The question Schairer and her colleagues have raised is whether this victory over one form...
...assumed that estrogen and estrogen-progestin were the same," says UCLA breast surgeon Dr. Susan Love, a prominent critic of hormone-replacement therapy. "Suddenly we are starting to get evidence that they're not." Like many others, Love is eagerly awaiting the findings of a large clinical trial launched by the Women's Health Initiative in 1993. That trial, which involves nearly 30,000 women between the ages of 50 and 79, is specifically designed to assess the pros and cons of estrogen-progestin therapy. The first results won't be ready for five more years...
...preventing bone loss and heart disease. The American Heart Association, for example, recommends the use of cholesterol-lowering drugs as the front-line treatment of choice for women whose blood lipids remain high despite diet and exercise. Similarly, there are new drugs designed to combat bone loss, including estrogen look-alikes that appear to act as antigrowth factors in the breast. As new and better drugs become available, the case for long-term hormone replacement will weaken...