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The Pharmaceutical Journal
Vol 268 No 7185 p197-203
16 February 2002

Related websites
Journal of the American Medical Association (jama.ama-assn.org)

Belief that HRT keeps women active challenged

In women without menopausal symptoms, HRT did not help them remain active and led to faster declines in energy

A new analysis of data challenges the widely held belief that hormone replacement therapy (HRT) helps women remain more youthful, active and vibrant, according to the authors of an editorial in JAMA (2002;287:641). They add that the study "provides additional evidence that hormone therapy may have an unfavourable benefit/risk ratio among older women who have cardiovascular disease".

American researchers analysed quality of life data for 2,763 postmenopausal women with coronary heart disease who took part in the heart and oestrogen/progesterone replacement (HERS) trial (ibid, p591). The women had been randomly assigned to receive either conjugated oestrogens 0.625mg and medroxyprogesterone acetate 2.5mg or placebo, for 36 months. The researchers say that the analysis shows that HRT has both positive and negative effects on quality of life in postmenopausal women with heart disease. It had overall negative effects on physical function, such as walking, but improved depressive symptoms.

The mixed effects of HRT on quality of life depended on the presence of menopausal symptoms. Therapy improved mental health and depressive symptoms in postmenopausal women with flushing. However, in women without flushing, it led to faster declines in physical function and energy/fatigue scores.

The researchers comment: "These mixed results suggest that hormone therapy does not have a general benefit for postmenopausal women with heart disease."

HRT and breast cancer risk Data published in JAMA support the hypothesis that recent long-term use of HRT is associated with an increased risk of breast cancer. In addition, the study suggests that HRT use may be related particularly to lobular tumours (2002;287:734).