Two interesting studies involving hormone replacement therapy (HRT) were in my local paper today. One study linked HRT to an increase in asthma and the other study linked HRT to a decrease in colon cancer. The asthma/HRT study was published in a medical journal, Thorax, and followed the treatment of 57,000 French women who were of menopause age to determine their risk of developing asthma. None of the women had asthma at the start of the study. The study kept track of what kind of hormone treatment they were on whether it was hormonal contraceptives or HRT and tracked them over a period of 10 years. This study found that women taking a combined HRT, or an HRT containing both oestrogen and progesterone were not more likely to get asthma but women taking only estrogen HRT were more likely to develop asthma than women who never take HRT. The estrogen only group was 67% more likely than the non-treatment group to get asthma, so this is a pretty substantial number. Once the treatment was stopped, the risk gradually reduced.
The colon cancer/HRT study was originally published in the American Journal of Epidemiology but as I said, I found a small blurb about it in my local paper so I don't have the original publish date. This paper is about a study conducted on 57,000 teachers in California. This study found that women undergoing HRT were 36% less likely to get colon cancer versus women who had never undergone HRT. Because of the other risks associated with HRT, such as strokes and heart disease, it is still ultimately not recommended to take HRT just to reduce the incidence of colon cancer. The study also found that once the women stopped taking HRT, their colon cancer risk returned to the same as that of the non-treated women.
It seems like a never ending saga when it comes to HRT. For years HRT was the standard treatment of choice for menopausal women, it was used to treat hot flashes and many other signs of menopause with great success. Unfortunately this treatment came with a host of side effects that ultimately proved the adage "the cure is worse than the disease". In the 1990's a large study was done by the Women's Health Initiative that showed that HRT reduced the risk of osteoporosis and colon cancer but increased the risk of strokes, breast cancer, embolisms, and heart disease. This study led many women and doctors to stop using and recommending HRT as the treatment of choice for menopause symptoms.
Despite these known risks, HRT is still in use today. For some women, this treatment is the only treatment that works for their symptoms so it is worth the additional risk. Usually HRT is used only for a short time and at the lowest dose possible to provide relief.
The studies I just happened to find in my local paper continue to cloud the HRT waters. It's somewhat of a bitter irony that the one thing that has proven the most successful at treating the vast majority of symptoms suffered by so many menopausal women is also potentially dangerous. But not only is it dangerous, it also has beneficial attributes. So, it works, it's dangerous, plus it has some positive health benefits.
Clearly we have not heard the last word on hormone replacement therapy, more studies will be done and more conflicting data will be disseminated. Where does this leave us? Well, all we can do is make the most informed decisions we can with the best information on hand and defer to our own judgment and the professional opinions of our doctors.
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