The Risks and Benefits of Menopausal Hormone Therapy in Younger and Older Women

Posted By SHL Librarian

Presented by: Marcia Stefanick, Ph.D.
Professor, Research, Stanford Prevention Research Center
November 16, 2006

Lecture Overview:
In one of the most stunning turnarounds in modern health care, it is no longer considered appropriate to give hormones to women to replace estrogen lost in the natural process of aging, i.e., at the time of menopause. According to Dr. Marcia Stefanick a series of myths became embedded in our culture, some of them actually hazardous, about using Menopausal Hormone Therapy (HT). In fact, it is now recommended that hormones are only given to menopausal women who have severe enough symptoms, for example, hot flashes and night sweats, that they feel they cannot carry on their normal lives, a far cry from the enthusiasm that once surrounded the use of HT with the expectation that it would prevent heart attacks, bone fractures, and dementia, and preserve youth. Dr. Stefanick discussed the landmark clinical trials that proved HT can, in fact, be harmful, by increasing heart attacks, strokes, blood clots, and dementia. Dr. Stefanick’s lecture recounted the highlights of several clinical trials that proved the new thinking on hormone use.

Furthermore, the truth is that there is relatively little known about hot flashes and night sweats or what a woman can to do, besides taking estrogen, to relieve these common symptoms. According to Dr. Stefanick a few useful hints include: dressing in layers that can be peeled off depending on the temperature, not wearing turtlenecks, and avoiding alcohol, caffeine and hot or spicy foods. Women are delighted by the simplicity and truth of this valuable advice. It is based on the fact that menopausal women do not dissipate heat well. There is also evidence that paced breathing might help. This is valuable advice indeed, as women everywhere await the results of new research initiatives that will hopefully yield a better understanding and clearer definition of menopause.

Stanford Health Library can do the searching for you. Send us your medical questions.

Links to the Clinical Studies:
The Framingham Study
http://www.nhlbi.nih.gov/about/framingham/index.html
http://www.framingham.com/heart/

The SWAN Study
http://www.edc.gsph.pitt.edu/swan/

The HERS Trial
http://www.nhlbi.nih.gov/whi/update_hers1998.pdf

Links to Dr. Stefanick’s Stanford Profile and her work:
http://med.stanford.edu/profiles/Marcia_Stefanick/
http://www.sciencewatch.com/march-april2004/sw_march-april2004_page3.htm

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