Cancer risk continues after HRT stopped

The Women's Health Initiative (WHI) trial of HRT in 2002 stopped early because cancer risks and heart disease were found while taking the treatment.


The Times reported that the same team conducted a follow-up study to 2005 monitoring 15,730 women with an average age of 63, originally included in the trial. The women were randomised to take either the combined HRT pill or placebo. The study found that three years after stopping the treatment, the risk of breast cancer was significantly higher than the placebo group, but other risks such as blood clots and strokes, return to normal after the women stopped taking the pills.


The research team pointed out that the findings should be interpreted with caution and suggested that to reduce the cancer risks, HRT should be used at the minimum effective dose and for the shortest possible time. The study was published in JAMA.

Source: "Health Risks and Benefits 3 Years After Stopping Randomized Treatment With Estrogen and Progestin" - JAMA. 2008;299(9):1036-1045 ( full text via Athens)

HRT risk for older women - WISDOM trial

A new multicentre, randomised, doubled blind placebo controlled trial was carried out in the UK, Australia and New Zealand to assess the risks and benefits of combined HRT vs placebo or oestrogen alone.

The results are consistent with the findings of the WHI ( US) study, researchers concluded that HRT "increases cardiovascular and thromboembolic risk when started many years after the menopause."


The study is published in the early online issue of BMJ, 11 July 2007. "Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women". Read the abstract .

The trial was prematurely closed after the WHI publication of the early results of the danger of HRT on older women. Read more...


See also previous post "Estrogen therapy and healthier arteries"

Estrogen therapy and healthier arteries

The level of calcium in the coronary arteries is an important predictor of future cardiovascular risks. A new study "Estrogen therapy and coronary-artery calcification" published on 21 June 2007 in NEJM, 356:2591-2602, found women between 50 and 59 who took estrogen had significant lower coronary-artery calcification than those who received placebo. However the authors note that "estrogen has complex biologic effects and may influence the risk of cardiovascular events and other outcomes through multiple pathways" and conclude that hormone therapy should be given with the lowest effective dose for the shortest duration.

In 2002, a WHI study indicated that women who took hormone therapy had substantially higher risk of heart attacks resulting in many women stop taking the drugs overnight.

In April 2007, WHI published a new analysis from 2 hormone trials to bring the effects into sharper focus by years since menopause. Read the summaries of the findings : "Postmenopause hormone therapy and risk of cardiovascular disease by age and years since menopause".