Hormone Therapy May Be OK for Some Women

The pendulum may be swinging back toward the use of supplemental estrogen - in low doses and for short periods of time - to help ease some symptoms of menopause.

A joint report from the International Menopause Society and the American Society for Reproductive Medicine says that estrogen therapy is best for treating hot flashes and night sweats brought on by menopause.

Although hormone therapy was widely used before 2002, most women abandoned it after a clinical trial found that the combination of estrogen and progestin increased the risk for heart disease, stroke, breast cancer, and blood clots.

Positive results

When researchers looked at the trial results for estrogen alone, though, they found that younger postmenopausal women could take estrogen for up to six years without significant risks.

Thus, says JoAnn E. Manson, M.D., president of the North American Menopause Society, older women shouldn't be afraid to seek treatment for menopausal symptoms.

Alternatives exist

Although estrogen is effective at relieving symptoms, it's not for every woman. Women who have a history of endometrial or breast cancer, or a history of heart attack, stroke, or blood clots should not take estrogen. Alternative treatments include antidepressants and the antiseizure drug gabapentin.

"There are some nonhormonal prescription medications that are better studied now than they have been in the past and may be very reasonable options, especially for women who are not candidates for hormones or who would prefer a nonhormonal option," Dr. Manson says.

Steven R. Goldstein, M.D., at New York University Langone Medical Center in New York City, agreed with the report's assessment of estrogen therapy.

"You need to look at an individual's family history and personal history, and make the most intelligent decision about [her] menopause treatments," Dr. Goldstein says. "There is no question that in general the harm that a lot of people associate with hormone replacement therapy is unfounded and overstated."

Dr. Goldstein has much less support for "bioidentical" hormone therapies, which typically come from soy or other plant sources. Most of these compounds don't have the proper ingredients in the correct amounts, he says.

Always talk with your health care provider to find out more information.