Dangers of estrogen therapy subject of yet another research study

As though women needed more convincing of the dangers of taking artificial hormone therapy, a study – published in the April 14, 2004, issue of the Journal of the American Medical Association (JAMA) – reveals that taking estrogen provides no overall benefit for chronic disease prevention in postmenopausal women with previous hysterectomy, but does appear to increase the risk of stroke and decrease the risk of hip fracture.

For years, the medical community has promoted estrogen and hormone therapy not only as a way to reduce the symptoms of menopause, but to prevent heart disease in certain women. Lately, however, nearly every research study has shown that the drug treatment doesn’t help – and usually increases women’s risk of disease.

The Women's Health Initiative clinical trials of hormone therapy were undertaken to determine whether Conjugated Equine Estrogen (CEE) alone (for women with prior hysterectomy) or in combination with progestin (medroxyprogesterone acetate) would reduce coronary heart disease events in mostly healthy postmenopausal women.

The estrogen-plus-progestin trial was halted in July 2002 because health risks exceeded benefits, including increased risks for heart disease, stroke and breast cancer.

In this new report on the estrogen alone intervention, investigators reviewed the effects of CEE, the most commonly used postmenopausal hormone therapy in the U.S., on major disease incidence rates.

In this randomized, double-blind, placebo-controlled disease prevention trial conducted in 40 U.S. clinical centers beginning in 1993, 10,739 postmenopausal women, aged 50-79 years, with prior hysterectomy were enrolled, including 23% of minority race/ethnicity. The women were randomly assigned to receive either 0.625 mg/day of CEE or placebo.

The researchers found that with an average of 6.8 years of follow-up, CEE had no significant effect on reducing the risk of CHD (376 cases) -- but did cause a significant increase (39% increase) in risk of stroke (276 cases) and a 12% increase in total cardiovascular disease.

CEE failed to produce any significant reduction in breast cancer, pulmonary embolism or colorectal cancer.

SOURCE: “Effects of Conjugated Equine Estrogen in Postmenopausal Women With Hysterectomy, The Women's Health Initiative Randomized Controlled Trial.” The Women's Health Initiative Steering Committee, Journal of the American Medical Association, April 14, 2004.