Weighing The Benefits And The Risks Of Hormone Therapy

(NAPSI)-To take hormones or not to take hormones? Many menopausal women ponder this question.

There is no doubt that hormones can help relieve menopausal symptoms, but recent studies have highlighted the potential risks of hormone therapy (HT).

In 2002, the Women's Health Initiative (WHI) found that prolonged use of HT with estrogen plus progestin caused a slight increase in the risk of breast cancer, heart disease and strokes. A few years later, a new look at the study suggested that certain younger women taking estrogen might actually have a slightly lowered risk of heart disease.

"Since the results of the WHI were first released in 2002, the public has been bombarded with conflicting information on how to interpret the findings," said Nanette Santoro, M.D., Director of the Division of Reproductive Endocrinology and Infertility at Albert Einstein College of Medicine. "This is a complex issue and patients should participate in continuous open dialogue with their physicians to arrive at treatment decisions best for their individual needs."

Based on the latest research, the U.S. Food and Drug Administration (FDA) recommends that hormone therapy (estrogen plus progestin) be used to relieve the symptoms of menopause at the lowest possible dose and for the shortest amount of time needed to relieve symptoms.

Each woman is a unique individual, so it's important that she discuss the benefits and risks of hormone therapy with her doctor as they apply to her particular situation.

When seeing your doctor, here are five tips to make the most of your visit.

1. Make a list of your symptoms and prioritize them, including how often you have them and how severe they are.

2. Learn about hormone therapy ahead of time.

3. Think about your own comfort level with the benefits and risks of hormone therapy before seeing the doctor.

4. Prepare a list of questions for your doctor.

5. Document your family health history.

Work with your doctor to reevaluate your treatment choices periodically so that you can confidently make the best decisions to navigate this period of change in your life.

For more information about menopause, visit www.hormone.org.

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Women Using Compounded 'Bioidentical' Hormones Miss the Full Story About These Drugs

/PRNewswire/ -- Women in, or past, menopause who use specially compounded "bioidentical" hormones to treat menopause-related symptoms, such as hot flushes, often don't get adequate information from compounding pharmacists about the drugs' risks and realistic potential for benefit. That's one of the concerns about these medications addressed by menopause expert JoAnn V. Pinkerton, MD, in "'Bioidentical' hormones: What you (and your patient) need to know," in the January issue of OBG Management.

So-called bioidentical hormones are chemically similar to hormones released by the body, including those produced in the ovaries -- estrone, estradiol, estriol, progesterone, testosterone, and dehydroepiandrosterone, to name some.

"The FDA has approved many prescription products that contain 'bioidentical' hormones," says Pinkerton, "but 'bioidentical' is often used to refer to custom-compounded hormones. The major difference between FDA-approved prescription bioidentical hormone products and custom-compounded products is that only the former are regulated by the FDA and tested for purity, potency, efficacy, and safety."

"That means it's up to physicians who prescribe compounded hormones to educate their patients -- about potential risks and benefits, absence of FDA oversight, purity and potency concerns, and lack of peer-reviewed data on efficacy and safety," Pinkerton says.

"Practitioners need to recognize that women who ask for these hormones may be vulnerable -- because of anxiety and depression that often accompany menopausal symptoms -- to unsubstantiated claims or recommendations of self-proclaimed experts."

"Compounded hormones aren't safer, or more effective, than traditional FDA-approved hormone therapies," Pinkerton emphasizes. "No data support individualized, personalized therapy based on testing hormone levels in saliva. And compounded bioidentical hormones don't prevent cancer; they probably have the same potential to cause cancer, and present the same other health risks, as FDA-approved hormones."

Bioidentical hormones are one of the biggest products of the multibillion-dollar US pharmaceutical compounding industry, observes Bruce Patsner, MD, JD, who contributed to the OBG Management article. Patsner, an expert on pharmacy compounding of prescription hormone therapy, served as senior medical officer at the FDA and is now Research Professor of Law at the University of Houston Law Center.

JoAnn V. Pinkerton, MD, is Professor and Vice Chair of Obstetrics and Gynecology at the University of Virginia Health System in Charlottesville, where she directs The Women's Place Midlife Health Center. She is a member of the Board of Editors of OBG Management, a review publication for ObGyns (www.obgmanagement.com).

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