No lingering effects from hormone pills

Research shows the pills were harmful only to women who started on them after age 60.

CHICAGO TRIBUNE

CHICAGO — The risks famously linked to post-menopausal hormone therapy largely vanish within a few years after women stop using the drugs, researchers reported Tuesday.

An average of 29 months after going off hormones, women no longer have higher odds of getting heart disease, according to the latest analysis from the federally funded Women’s Health Initiative. And although a few extra cases of breast cancer were found, the difference was not statistically significant.

The study is published in this week’s Journal of the American Medical Association.

The question of lingering effects from hormone therapy is especially relevant because so many women went off the drugs in 2002. That was the year researchers with the Women’s Health Initiative dropped a bombshell: The huge research project, which was set up to see if giving hormones to healthy post-menopausal women could prevent heart disease, found that using the pills actually caused a few extra cases of heart disease and breast cancer.

It also found hormones prevented some hip fractures and colon cancer, but the project was halted abruptly. Overall, the conclusion was that women should not take hormones in hopes of preventing future health problems.

Women and doctors had believed for decades that hormone therapy was heart-healthy. Sales of hormone products plummeted as women went off their pills, choosing to risk hot flashes and brittle bones rather than heart attacks and breast cancer.

However, as the researchers “drilled down” into the data, analyzing it in detail, more subtle findings have emerged.

For one, they found that hormones — both estrogen alone and combination pills — actually are heart-healthy for women who start taking them at or around menopause. The pills were found to be harmful only for women who wait until after 60, when they probably have some cardiovascular disease already.

However, concern remained over the increased risk of breast cancer for women who took combination hormones — a worry reinforced last year when it was reported that the national incidence rates of breast cancer dropped as women went off hormone therapy.

The latest results show that virtually all differences seen in 2002 between the women who took Prempro (a combination of synthetic estrogens and progesterone) and those who took a placebo had disappeared by 2005. The increased risk of heart attacks, strokes, blood clots and breast cancer was gone, as was the decreased risk of fractures and colon cancer.

One unexpected result was a larger number of cancers of all kinds — including lung cancer — in the women who had been on Prempro.