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Older women should avoid HRT

Now there is one more reason for older women to avoid hormones replacement therapy (HRT) after menopause. According to new findings, most older women should not be taking hormones because the risks outweigh the benefits.

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Now there is one more reason for older women to avoid hormone replacement therapy (HRT) after menopause. According to new findings, older women without menopausal symptoms should not be taking hormones because the risks outweigh the benefits. Researchers at the University of California at San Francisco studied 16,608 post-menopausal females. Hormone treatments may be justified for women with menpausal symptoms like flashes and night sweats. But only 10 to 20 per cent of women fall into that category and they should be started on a low dose that is gradually increased until the symptoms disappear. Debate has raged for years over the wisdom of hormone therapy amid conflicting reports over whether it prevents brittle bone disease and heart disease. They found that any physical or emotional improvements felt by the 8,506 women who got the hormones were not meaningful and faded after the first year. The 8,102 women who received placebo treatment had the same levels of sexual activity, insomnia and depression as women who received the estrogen and progestin. Some previous findings indicated the estrogen-progestin combination produced small declines in hip fractures and colon cancer, even as it increased the risk of stroke, breast cancer, heart attack, and blood clots in the lungs. Overall the risk of complications benefits; one in 100 women on HRT for five years will suffer a serious complication. However treating women with estrogen and progestin does little to enhance their quality of life unless the hormones are being used as a short-term therapy to block hot flashes and night sweats.

The New England Journal of Medicine, April 2003; Vol. 348(19)

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