Hormone Replacement Therapy: A Risky Business

Hormone Replacement Therapy (HRT) is like a vampire. No scientific wounds ever kill it because the financial motivation to keep pushing it is simply too great to resist.

The precursor to HRT was estrogen replacement therapy (ERT), touted in the mid-'60s as a way for women to stop the aging process and eliminate the unpleasant symptoms of menopause. The first blow to ERT came in 1975 with a study showing the risk of endometrial cancer was 4.5 times greater in women taking estrogen (14 times greater if taken for more than seven years). There was some evidence that including progesterone would reduce this risk, thus HRT was born (using artificial progestin).

The risk of cancer still exists with HRT. A 1995 study estimated the risk of fatal ovarian cancer as 15 to 71 percent higher, depending on the duration of HRT. A 2002 study showed a 60 to 85 percent increased risk of breast cancer. Risk of stroke has been shown to be about 50 percent higher.

In other cases, the touted benefits have failed to be proven. Recent studies have showed that HRT does not slow down the onset of Alzheimer's, nor does it measurably improve quality of life or lower rates of coronary heart disease.

Hormones are big business for many doctors and drug companies. Pharmaceutical industry-sponsored Web sites, and even government health information sites, still promote ERT and HRT and downplay the risks.

Women approaching menopause should consider the risks of the quick-fix approach embodied in HRT, and understand that current enthusiasm may arise from the marketing efforts of pharmaceutical companies. Alternative approaches based on diet, exercise and natural estrogens may not be patentable, but they may be more successful and certainly carry less risk.