Hormone Replacement Therapy: The Whole Story

Hormone Replacement Therapy: The Whole Story (<i>cont'd</i>)

But two studies published in early 2000 pointed out that combining synthetic progesterone with estrogen as hormone replacement therapy for menopausal women actually increased the risk of breast cancer, particularly in thin women thought to be at lower risk for the disease. In the study reported in JAMA in January 2000, the risk of breast cancer was 40 percent higher in women taking combination HRT than in women who had never used hormones. Another study reported in the Feb. 16, 2000, Journal of the National Cancer Institute reached the same conclusions.

What's the Alternative to Hormone Replacement Therapy?

The cancer statistics, plus the new research on estrogen and the heart, are giving some women "more motivation to say 'well, maybe I don't really need this,'" said Tori Hudson, N.D., a naturopathic physician in Portland, Ore., who specializes in menopause. She recommends that women find alternatives to the traditional menopause medications.

Diane Lehman of McLean, Va., has tried estrogen three or four times, but it always made her feel "weird," she said. "I just know my body doesn't like this stuff." Some women, like Melissa Herman of Bethesda, Md., check out the pros and cons of estrogen and decide to avoid it completely, despite pressure from their doctors to do otherwise. When Herman went through menopause at age 50, her symptoms were mild and no one recommended estrogen medication.

Now at age 59, she's being "bombarded by all this stuff about taking hormones," she said. "My doctor had me frightened that I'd fall over jogging if I didn't take estrogen." But her fear of cancer overrules her concern about osteoporosis. Instead of taking estrogen, she runs, eats a good diet and takes vitamins.

But none of the cardiac research or breast cancer alarms have changed Shirley Waddell's mind. She's staying on the medication. She gets a mammogram every year to screen for breast cancer. She's confident that the estrogen is preventing her from developing osteoporosis, which runs in her family.

Women need to make up their own minds about estrogen, doctors and patients say. "I make decisions for me, and I think all women should make their own decisions," Herman said. "Every woman needs to determine what her benefits and risks are."