Postmenopausal hormonal treatments at issue

2002/07/10 Carton Virto, Eider - Elhuyar Zientzia

• Osasuna

Many women receive hormonal treatments to combat the effects of menopause. The American organization Women’s Health Initiative launched in 1997 a research session on the long-term effects of one of these treatments and decided to abandon them on May 31. Although the session ended in 2005, the risk of developing heart disease and breast cancer became too high in five years. The results of the study have been published in the Journal of the American Medical Association and are available free of charge online.

Given the concern and fear of this type of news, it is worth contextualizing the research first of all, since, although significant, the results do not serve for any hormonal treatment. Women participating in the study took a single dose of 0.625 mg of estrogen (EEC estrogen) and 2.5 mg of progestins (progestin MPA) orally every day. And they all had the uterus in good condition. Those responsible for the research have stated that the results cannot be extended beyond there, as a lower dose of the same formulation, other formulation or the use of hormones by other means may have a different risk and benefit profile.

In Europe the pill used in the session is not sold, other similar ones are used.

Imbalance between risks and favors

The Women’s Health Initiative study looks at heart disease, breast cancer, colon cancer, and the risk of hip breakage. 16.608 women aged 50 to 79 years, half hormones and half placebo participated.

Five years later, women in the group that was taking the hormone have seen their risk of developing breast cancer increase by 26% and research has remained there. The risk of developing heart disease has increased by 29% and the risk of suffering a heart attack by 41%. For heart conditions, the risk is highest during the first year of treatment. The risk of developing breast cancer increases from age 3. In contrast, hormone treatment protects women against colon cancer and osteoporosis.

The percentages seem very high, but if you look at the absolute data the situation is not so dark. Absolute data is given at 10,000 and annually. In the case of this study, the use of hormones means that in this group there will be 8 more cases of breast cancer and 8 cases of heart in a year, but in return 6 cases of colon cancer less and 5 hip fractures less. The numbers are small.

However, those responsible for the investigation have considered that the favors are much lower than the damages and, as already indicated, have considered it safer to cancel. Similar results have been obtained previously, but so far such extensive research had not been conducted.

Within the same session, but in another group, the influence of estrogens is being studied. In this case, women take estrogen or placebos and all have the uterus torn. This research continues and is expected, once completed in 2005, to provide new data of interest.