Like so many women in their fifties, Wanda Hamlin was encouraged by her doctors to use hormones to fight osteoporosis and other effects of menopause. She thought it seemed like a simple way to improve her health.
"There's not much I can do about that. It was what they claimed to be an accepted treatment," Hamlin said. And like most women, 60-year-old Hamlin abruptly stopped hormone replacement therapy in 2002, when researchers discovered those daily pills could trigger heart disease, and stroke and cancer. "What I was really getting were additional risks to my health, and that it was surprise and certainly something to be concerned about," she said. The study out this evening is the first to look at what happens to women years after they stop using that combination of estrogen and progestin. The good news is that researchers found no added risks for blood clots causing heart attack and stroke. Dr. Joann Manson of Brigham and Women's Hospital said, "Shortly after stopping hormone therapy, even within several weeks or a couple of months, these clotting factors and other proteins return to normal." The bad news, however, is an increased risk of cancer - especially breast cancer. Though the increase is slight - a fraction of one percent more cases among the women on hormone therapy - it's still there even after women stop taking the hormones. "It's actually what we expected," Dr. Joanne Pinkerton of the University of Virginia said. "That there would be some slight risk at two-and-a-half years. But we would expect that risk to be gone by five years." Doctors say women can minimize the effects with regular cancer screening, especially annual mammograms. Women who have taken therapy should also discuss with their doctors reasons for treatment. The study out this evening does not address those women currently on hormone replacement therapy, typically at half the dose for only a couple of years, and whether it's much safer. Researchers say the latest findings apply to women who were on hormone replacement for an average of five years - prior to 2002. Current hormone therapy is only recommended for two to three years at most and often at about half the traditional dose. Dr. Larry Norton, director of breast cancer programs at Memorial Sloan-Kettering Cancer Center, distilled the results this way: "If you are taking HRT [hormone replacement therapy], try to stop. If you are not taking HRT, don't start." Dr. Norton noted that there are plenty of safer ways to treat osteoporosis and post-menopausal symptoms, should they develop. Estrogen alone is only potentially applicable to women without a uterus, he said. For those like Hamlin, who stopped taking hormones years ago, they continue to wait and wonder how much longer they must live with the risks.