Friday, July 12, 2002 | 11:08 a.m.
Eileen Reynolds, 68, started taking estrogen and progesterone 18 years ago, because she kept "having sweats" during menopause.
She kept on taking them because her doctors in Los Angeles advised her to do so to prevent osteoporosis, and when she moved to Las Vegas 10 years ago, her gynecologist recommended the same course of treatment.
Her bones, she said, "feel stronger now than they did when I was in my 20s," and her posture is perfect.
Despite this apparent success, "I stopped taking all the drugs" this week, Reynolds said. "My doctor's out on maternity leave, so I couldn't discuss it with her, but after I saw those reports, I just stopped. I don't really know what to do now."
Reynolds, like more than 6 million American women and their OB/GYNs, is faced with a difficult choice now that the Women's Health Institute this week announced it was halting a long-term study of estrogen-progesterone therapy.
More than 16,000 mostly healthy women between the ages of 55 and 86, including 309 participating in the trial through the University of Nevada, Reno, received a letter earlier this week advising them to stop taking their drugs immediately. Researchers, who had hoped to show the drugs prevented heart disease, instead found that after more than five years on the drugs:
Despite these findings, many Southern Nevada health-care practitioners are concerned that women who would benefit from the medication will be needlessly frightened now. The study only applies to women who have not had hysterectomies and were taking a both estrogen and progesterone; 11,000 women who have had hysterectomies are still participating in a separate WHI study.
"I would hesitate telling women to stop taking their medication until they talked to their individual doctors," cautioned Martha Drohobyczer, a certified nurse/midwife at Alternatives for Women.
Drohobyczer not only prescribes hormone-replacement therapy, she has been using it herself for years and has seen its benefits firsthand.
"Women are panicked enough in our culture," she said. "We already feel like our bodies are time bombs set to go off. Now almost anything women take, we feel trapped."
Dr. Warren Volker, research director at the Las Vegas campus of the University of Nevada School of Medicine in Reno and a member of the national Council for Hormone Education, agreed.
"There's a risk-benefit ratio in taking any medication," Volker said. "We definitely know that hormone replacement decreases the risk of colon cancer and osteoporosis and bladder dysfunction and controls hot flashes and mood swings. So I think we need to look a lot more closely at this study before we just dismiss those benefits."
Longtime hormone user Evie Kinney, 64, noted that for some women, hormone therapy is vital.
"The important thing is not whether you take hormones," she said, "but how you take it and how much you take. The dose is very important. I tried the patches and my skin blistered. I tried the shots and my breasts were sore. Another kind made my skin break out. I had to work with them to get my dosing fixed - but I need these hormones because of my hysterectomy."
Some women, however, were suspicious of hormone therapy long before the WHI study was aborted.
Hilda Smith, 68, a jewelry sales associate at JC Penney in The Galleria in Henderson said her doctor urged her to take hormones when she underwent menopause, "But I went the herbal route instead."
Smith based her decision on her family history: "My mother never took hormones. Her sister, who was four years younger than she was, took them for years. They both still had osteoporosis, but my aunt died of heart disease six years before my mother did, even though she was the younger one."
Studies linking hormone-replacement therapy with breast cancer are not new, and doctors routinely warn their patients of this danger now when prescribing the medications to treat menopausal symptoms or prevent osteoporosis. The WHI study, however, provides what it called "the first definitive data" showing the medications almost immediately increase the risk of coronary heart disease, more gradually increase the risk of stroke and progressively increase the risk invasive breast cancer.
While many women have been prescribed hormones for 10, 15 or 20 years, the new study results suggest that the best course of treatment for routine menopause symptoms, including mood swings and hot flashes, may be a brief hormone regimen of a year or two.
"Each woman has to decide whether her menopausal symptoms are so severe that they are worth that risk," said Dr. Robert Brunner, Principal Investigator of the Women's Health Initiative in Nevada. "If someone is having debilitating symptoms, that's up to them to decide whether that's something they want to put up with. On the other hand, I do think doctors will prescribe less casually now."
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