Estrogen pills: Are health risks overblown?

Pills of many shapes and colors grouped together iStockphoto

Pills of many shapes and colors grouped together
iStockphoto

(CBS/AP) Are estrogen supplements safer than women have been led to believe? A new study shows that stroke and other health problems linked to the pills fade when women quit taking them after menopause.

It's good news for women who take the hormone in their 50s, when menopause usually begins.

The study bolsters previous research showing that concerns about breast cancer and heart attacks are largely unfounded for women who take the hormone for a short period of time to relieve hot flashes and other menopause symptoms.

Estrogen-only pills are recommended just for women who have had a hysterectomy, and the study focused on that group. About 25 percent of women in menopause have had hysterectomies. Other women are prescribed a combination estrogen-progestin pill because for them, estrogen alone can raise the risk for uterine cancer.

The study results don't really change the advice doctors have been giving for years now: Take hormones to ease menopause symptoms in the lowest possible dose for the shortest possible time.

The women in the study took estrogen for six years and were evaluated for four years after stopping. Slightly elevated risks for strokes and blood clots that were found while they took the pills disappeared during the follow-up. But the bone-strengthening benefit of estrogen disappeared, too. Once women ended it, they had just as many hip fractures during the follow-up as women who'd taken dummy pills.

The research also found that women who started taking estrogen-only pills in their 50s fared better after stopping than women who'd started in their 70s - an age when hormones are generally no longer recommended.

"Our results emphasize the need to counsel women about hormone therapy differently depending on their age and hysterectomy status," the researchers said in reporting the study to be published in Wednesday's Journal of the American Medical Association.

The new results are from 10,739 participants in the estrogen-only part of the federal government's Women's Health Initiative study - research that shook up conventional wisdom about health benefits of hormones for menopausal women. Study of the estrogen-progestin group was halted in 2002 when risks for heart attack and breast cancer were linked with the combination hormone pills. The estrogen-only study was halted in 2004 after stroke risks were seen in that group.

The troubling findings led many doctors to stop prescribing the pills to prevent chronic health problems - and led millions of women to stop taking them.

Doctors now generally recommend hormones only to relieve hot flashes, sleep-disrupting night sweats and vaginal dryness in the lowest possible dose for the shortest possible time. Dr. Jacques Rossouw, who directed the initial research at the National Institutes of Health, said the estrogen follow-up results reinforce guidance "that women can use it shortly after the menopause for a limited period of time and then stop."

  • David W Freeman

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