Laurie and Debbie say:
News flash! (Good for hot flashes). Hormone replacement therapy may be good for you after all.
Almost every woman over the age of 30 will remember the news blitz in 2002 when the Women’s Health Initiative turned up some increases in various diseases and conditions, including breast cancer, linked to taking estrogen plus progestin.
We weren’t blogging then, but we were paying attention (and Laurie was on HRT). While the news media, the medical establishment, and tens of thousands of individual women were rushing to flush pills down the toilet and rip up prescriptions, we were looking at numbers and we were stunned by the intensity of the social response.
“Among 10,000 postmenopausal women [who have not had their uterus removed] who are taking estrogen plus progestin, eight more will have invasive breast cancer, seven more will have a heart attack, eight more will have a stroke, and 18 more will have blood clots, including eight with blood clots in the lungs, than will a similar group of 10,000 women not taking these hormones.”
In other words, in this group which included women up to age 79, assuming that every bad outcome counted above happened to a different person (so that none of the blood clots were related to strokes, for example), less than one-half percent per year had a bad outcome. If numbers that small have any statistical confidence, which we doubt, then over 20 years, 800 of the 10,000 women will have one of the four bad outcomes–many of which, of course, are not fatal or long-term devastating.
Now, the Nurses’ Health Study, a long-term study of 121,000 women ages 30-55 shows a 30% reduced risk of heart attack in women who start taking HRT when they first start experiencing menopausal symptoms. This isn’t “proof” either; what it is is a study of 6 times as many people over many more years, showing much more statistically important effects.
When the WHI results were released in 2002, the study was cancelled midstream because of not wanting to “kill more women”; the newspapers were full of scare headlines; the medical profession as a group jumped onto the “stop taking hormones now” bandwagon; and the vast majority of women stopped taking HRT.
The biggest factor here was probably fear of breast cancer, and at the same time, we also saw a widespread belief that the male medical establishment had somehow been engaged in a conspiracy to keep women sexualized longer. Neither of us is inclined to trust the medical establishment, which is certainly still significantly male. At the same time, it isn’t our experience that most men are interested (or even believe in) the sexual feelings of older women anyway.
Women take HRT because it makes them feel better, healthier, sexier, and more able to be active. The rush to judgment which caused literally millions of women to go off HRT in the wake of the WHI study (which was cancelled midstream because of the “dangerous” findings) resulted in 9,200 of every 10,000 affected women giving up something that she presumably found worthwhile, for a risk that looks minuscule to us.
The new study will increase confusion and make it harder for individual women to make good assessments of what they should do. The bottom line, of course, is that we need to have (and the powers-that-be who affect our decisions need to have and need to share) full, detailed, and thoughtful information so that we can make smart choices.