Is hormone therapy ok for menopause? Brigham specialist says 'benefits far outweigh the risks'
BOSTON - Up to ninety percent of women going through menopause develop sometimes debilitating symptoms. The most effective treatment is hormone therapy, but many doctors won't prescribe it. However, that may be changing.
When 52-year-old Vogal James developed exhaustion and night sweats, she thought she was coming down with something. But it wasn't the flu, it was menopause.
"I was just like, 'Clutch my pearls. What do you mean menopause?" she said.
Thirty years ago, most women like James were given estrogen, often with progesterone, not only to treat menopausal symptoms like hot flashes, fatigue, and mood swings, but also to reduce their risk of chronic disease.
Then a landmark study published in JAMA in 2002 found a small increased risk of heart disease and breast cancer in women taking hormones, but the average age of women in the study was 63. Yet, women in their 40s and 50s were all of a sudden told to stop using their hormones.
Dr. JoAnn Manson, an endocrinologist at Brigham and Women's Hospital, was the lead author of the study.
"The report led to a great deal of alarm and confusion," she said. "It was never stated by the WHI investigators that women taking hormone therapy should immediately toss their pills and patches. But that is how the results were interpreted."
It led to a seventy-to-eighty percent reduction in the use of hormones, leaving millions of women without relief and most clinicians not even willing to discuss them as an option. But that is changing, according to Dr. Tara Iyer, a menopause specialist at the Brigham.
"You should be able to feel you're the best version of yourself on every single day," she said. "The data frankly shows that certain candidates, in healthy younger women with no contraindications, the benefits far outweigh the risks."
"We started on estrogen, and it's been a game changer. What I want women to have is control of their menopause," James said.
If you're having trouble finding a provider to discuss the risks and benefits of hormones, you can go to the North American Menopause Society website for a list of local clinicians trained in menopause management.
