No more HRT! NOW what'll I do?

I’m 45, and if things go normally, menopause should kick in in 5-10 years. Hey, no problem! I’ll just take hormone replacements!

BZZZT! Not now. Although the recently published results of a large HRT study were in reference to long-term HRT, I’ve read quotes from doctors stating that short-term HRT should be still safe. Well, isn’t that fine and dandy! So -

  1. How do they know that?
  2. It sounds to me that short-term HRT just delays the onset of menopausal symptoms for a couple of years. What’s the point?

Piss. I’ve just been experiencing the first few hints of peri-menopause lately, and I was comforted by the idea that I could eventually take hormones to help me deal with it. Not now. Waaaaah!

No freakin’ kidding. (41 here). Sounds like a huuuuge overreaction to me. I can’t remember where I read it, but I saw someone musing about what the response would be if Viagra were withdrawn suddenly due to a small percentage of bad reactions (of which I’m sure there must be some.) She was wondering how men with erectile disfunction would like it if they were told to wear loose clothes and think positive thoughts.

Hot flashes? No, I’m just extra radiant today.

I just turned 49. I’d been taking HRT since October. I decided to
stop the pills and see exactly what symptoms I’ll have. Maybe they won’t be so bad. I can always start taking them again if I
NEED to. Why put the medicine in me if I don’t really need it?

IMWOMANHERE, why don’t you post back at some point and let us know how you fare after stopping HRT? Did your doctor just write you the prescription automatically because of your age or were you experiencing some really nasty symptoms?

I’m hoping Dr. Qadgop adds his two cents to this threads, although if he keeps that position as inmate physician, I doubt he’ll be seeing many menopause cases . . .

“withdrawn suddenly due to a small percentage of bad reactions”

errr… it wasn’t a small percentage.

From Reuters:

"The trial showed that women taking Prempro had a 26 percent higher risk of breast cancer than those taking placebos, or dummy pills.

It also showed that the combination drug lowers the risk of colon cancer and hip fracture, but raised the number of strokes by 41 percent and the number of heart attacks by 29 percent."

They actually cancelled the entire study, which was due to run until 2005, because it was not worth the risk to participants.

Anyhoo, the big dirt is on Prempro. I’m not sure that any of the other HRTs have been specificaly implicated.

I’m just wondering-- does that mean it went from a 4% chance to a 5.1% chance of breast cancer? 'cos that would be “a 26% higher risk.”

As a journalist, I wouldn’t trust a damn thing any so-called medical reporter writes. Most of my colleagues can’t balance their chequebooks, let alone understand statistics.

Hmmm… good point. The original article, as published in JAMA, can be found here:

Looks like they mean that the incidence of cases increased by that percentage. I believe I’ve pulled the relevant explanation from that report. Please correct me if I’ve misunderstood anything:

"Overall CHD* rates were low (Table 2). The rate of women experiencing CHD events was increased by 29% for women taking estrogen plus progestin relative to placebo (37 vs 30 per 10 000 person-years), reaching nominal statistical significance (at the .05 level). "

"Stroke rates were also higher in women receiving estrogen plus progestin (41% increase; 29 vs 21 per 10 000 person-years), with most of the elevation occurring in nonfatal events. Women in the estrogen plus progestin group had 2-fold greater rates of venous thromboembolism (VTE), as well as DVT and PE individually, with almost all associated CIs excluding 1. Rates of VTE were 34 and 16 per 10 000 person-years in the estrogen plus progestin and placebo groups, respectively. "

"The invasive breast cancer rates in the placebo group were consistent with design expectations. The 26% increase (38 vs 30 per 10 000 person-years) observed in the estrogen plus progestin group almost reached nominal statistical significance and, as noted herein, the weighted test statistic used for monitoring was highly significant. No significant difference was observed for in situ breast cancers. Follow-up rates for mammography were comparable in the estrogen plus progestin and placebo groups. "

*Coronary Heart Disease, right?

pugluvr, you’re right, I don’t see many females at all. I’m still digesting the news about hormones, and I’m not even sure exactly what to tell my wife. But if one is on them for perimenopausal symptoms for a year or two or three, so far I don’t think that adds up to much risk. For long-term HRT after menopause, best have a conversation with your own doc. Actually, for questions about short term use, best talk to your own doc too.

Having said that, I do wish to emphasize it’s not an issue to panic over or feel needs to be decided today or even this week. There is time to find the answer right for the individual.

I plan to try HRT for short term use for the nasty symptons; I’ve always planned on that, and the new study, which tracked use over 5 years, has not changed my mind.

I would like to hear what an enlightened medical doctor thinks about botanical products that are suposed to ease the symptons of hormonal imbalance. They can regulate the reproduction of kangaroos …

I plan to try HRT for short term use for the nasty symptons; I’ve always planned on that, and the new study, which tracked use over 5 years, has not changed my mind.

I would like to hear what an enlightened medical doctor thinks about botanical products that are suposed to ease the symptons of hormonal imbalance. They can regulate the reproduction of kangaroos …

I’ve been on HRT for a little over a year because of the dreaded hot flashes. I’m a medical librarian, read the JAMA article and discussed with assorted doctors on staff. Short-term use seems to be o.k. If the d.h.f. didn’t wake me up every hour I’d go off HRT simply because I wouldn’t need it. The risks of HRT were always there. IMHO, the media jumped on this and made it sound as if HRT was touted as a “no risk, miracle cure” when it really never was. All pharmaceuticals have some risk. You just have to decide if you want it.

Wasn’t the study showing that you had those increased chances if you took them for more than 5 years?

I thought the whole point of HRT was to slowly reduce the dosage so your body adjusted gradually.

Anyway, I’m not sure why anyone found these results suprising? You’re using artificial hormones to alter your bodies natural functions… To expect there to be no side effects is… not reasonable.

Anyway, the actual number value increases aren’t that large. 27 vs 21… I’d say, judge your symptoms and think about the risk vs the benifits. If anything, I think this allows women a more informed decision.

Actually, the most interesting point of the study was that this specific hormone replacement was presented as preventing some of the medical problems that increase after menopause, and this study suggests that it is not worth the risk of other medical problems. It’s like Listerine claiming it could prevent colds.

The risk of strokes and heart-attacks can be influence by diet and exercise, but colon and breast cancers can not. (I mean that I have heard of no definitive studies that show they can be.)

I wonder how women who ate lots of leafy green vegetables, smaller servings of meat, and extra calcium fared on HRT.

I went through early menopause and have been taking HRT for a few years. I actually took Black Cohosh and Dong Quai (herbs) at first that took care of my symptoms, but decided to take HRT because I am at risk for osteoporosis. My mom had a mild case of that, but during her fight with cancer (for reasons related to her initial surgery) she got compound fractures in her spine (I think that is what it was called, I might not be remembering correctly). And I am here to tell you…she was in AGONY with them. She experienced MUCH more pain with them than she ever did with the cancer.

So, since I am already at risk…celtic heritage, NEVER drank milk or took calcium supplements as a teenager, small boned etc) I decided to go with HRT. I don’t know what to do now. I know if I still have symptoms I can control them with the herbs, but …I don’t want to increase my risk to get osteoporosis.

I phoned my Doc, and he said not to panic…he is looking into this and I should keep taking the HRT until he determines what the best course of action will be.

So far that is what I am doing. But I don’t like it.