Doctors take another look at safety of hormone therapy

Data analysis suggests the treatment is safer in the decade after menopause than later on. Also, the FDA acts to rein in bioidentical hormones.

By Victoria Stagg Elliott, AMNews staff. Feb. 18, 2008.

Physicians increasingly are talking about prescribing hormone therapy for recently menopausal women. Meanwhile, regulators are cracking down on claims about compounded formulations, according to statements issued in January.

With regard to traditional hormone therapy, the American Assn. of Clinical Endocrinologists published on its Web site last month a position statement saying this strategy is safe for women who are younger than 60 or who are less than a decade past menopause and is a viable option for those experiencing symptoms related to this life change.

"We looked at the data carefully, and the data show that a woman who is a long time past menopause has a very different clinical course than a woman who is younger," said Richard Hellman, MD, AACE president.

This step is the latest by physicians trying to refine the use of postmenopausal hormone therapy, which was encouraged for nearly all women until July 2002, when results from the Women's Health Initiative were published in the Journal of the American Medical Association. That study found the approach increased the risk of coronary heart disease, stroke, pulmonary embolism and breast cancer. Sales plummeted as women looked for other options, and most clinical guidelines were changed to recommend that the therapy be used at the lowest dose for the shortest time possible.

"The pendulum has been swinging back to at least looking at the option," said LeRoy Sprang, MD, clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine in Chicago. "It's very reasonable to offer women low-dose hormone replacement." Dr. Sprang is also a member of the AMA's House of Delegates, although he was speaking personally.