Revised 8/26/02njm

DRAFT Letter to patients

The July news release on the Women’s Health Initiative Study about Hormone Replace Therapy (HRT) left many women unsure of their health choices.

Southcentral Foundation and Alaska Native Tribal Health Consortium would like women to make an appointment at the earliest date with their health care provider, to talk about their health care options and decisions related to menopausal issues.

Introduction

• HRT is in option for women who no longer have estrogen because of menopause or surgery.
• Combined HRT has both risks and benefit in terms of future illness.
• It is not recommended that a woman take HRT for the purpose of preventing disease.
• A woman can choose to use HRT to treat the symptoms of estrogen deficiency.

· If HRT doesn't significantly improve the quality of your life you should not use it. It would be helpful to keep a diary to monitor your health and discuss with your health care provider.

• If you choose to use HRT you should be fully informed about the current best assessment of risk.
• Other sources of hormones to treat menopausal symptoms have not been evaluated for safety or benefits.
• There may be benefits beside prevention of colon cancer, osteoporosis, and improvement of vasomotor symptoms, for example, Alzheimer's cognition, or other findings.

Information for patients using the drug Prempro or similar generic combination

(Combination of conjugated estrogens 0.625 mg and medroxyprogesterone 2.5 mg)

• Decreased risk of hip fracture (5 less /10,000) per year
• Decreased risk of colon cancer (6 less /10,000) per year
• Increased risk of breast cancer (8 more /10,000) per year
• Increased risk of heart attack, or other coronary event (7 more /10,000) per year
• Increased risk of stroke (8 more /10,000) per year
• Increased risk of blood clots in the lungs (8 more /10,000) per year
• Overall increased risk of above events combined (20 more /10,000) per year or 1/100 over 5 years

Other risks of hormone replacement therapy also discussed include:

Increased risk of cancer of the uterus

May worsen diabetes

Not to be taken in pregnancy, liver disease, stroke, breast cancer, uterine cancer,

Abnormal vagininal bleeding, or blood clotting

Other side effects include:

Blood clots, nausea, abdominal. pain, breast tenderness, irregular bleeding,

headache, and hair loss among others.

Talk to your health care provider about your individual choices, risks and needs. Whether you have made the choice to begin, continue or discontinue HRT, discuss the healthy lifestyle measures for women in the middle years with the help of your provider.

Phone 729 ------- today, to book your appointment.