Menopause Symptoms May Come
Back After Stopping Menopausal Hormone Therapy
Some women who use a combination of estrogen and progestin
to control the symptoms of menopause might find symptoms
return when they stop the hormones, according to the
latest findings from the Women’s Health Initiative
(WHI), a major clinical trial of the risks and benefits
of menopausal hormone therapy supported by the National
Institutes of Health (NIH).
Of those women in the study who had symptoms such as
hot flashes, night sweats, pain, or stiffness when
the study started, more than half found that these
symptoms came back when they stopped menopausal hormone
therapy. A smaller percentage, who did not have symptoms
before, developed them after stopping the hormones.
Women stopped using the study pills when the trial
was halted in July 2002 following the discovery that
the risks of using these hormones, including increased
heart disease, outweighed the benefits such as prevention
of fractures. Women who described their symptoms as
moderate to severe before the study were more likely
to have them come back than women with mild symptoms.
These study results will be reported by Judith K.
Ockene, Ph.D., University of Massachusetts Medical
School, Worcester, and other WHI investigators in
the July 13, 2005, issue of the Journal of the
American Medical Association (JAMA).*
“Before this study, we knew little about the
effects a woman experiences when she suddenly stops
menopausal hormone therapy use,” said Sherry
Sherman, Ph.D., of the Geriatrics and Clinical Gerontology
Program at the National Institute on Aging (NIA).
“Now women are learning that their symptoms
might return, even after using these hormones for
more than 5 years.”
An estimated 2 million American women go through menopause
each year. The Women’s Health Initiative found
that women ages 50-79 years should not use menopausal
hormone
therapy to prevent heart disease or dementia. But,
if women are bothered by moderate to severe menopausal
symptoms, the Food and Drug Administration recommends
that they can use estrogen (with progesterone if the
woman has her uterus) at the lowest effective dose
for the shortest time needed to manage them.
The WHI is funded by the National Heart, Lung, and
Blood Institute (NHLBI) and conducted in collaboration
with the National Institute on Aging, National Cancer
Institute, National Institute for Arthritis and Musculoskeletal
and Skin Disorders, and Office of Research on Women’s
Health.
Detailed information on menopause may be found in the
NIA’s brochure, Menopause: One Woman’s
Story, Every Woman’s Story and its updates,
http://www.niapublications.org/pubs/menopause/index.asp.
A description of the Women’s Health Initiative
is available online at http://www.nhlbi.nih.gov/whi/index.html.
An NHLBI fact sheet on menopausal hormone therapy
is available online at http://www.nhlbi.nih.gov/health/women/pht_facts.htm.
To reach Dr. Sherry Sherman, Project Official of NIA’s
Study of Women’s Health Across the Nation (SWAN)
and Planning Chair of NIH’s recent State-of-the-Science
Conference on Management of Menopause-Related Symptoms,
please contact the NIA Office of Communications and
Public Liaison at 301-496-1752. To reach Dr. Ockene,
lead author of the new study, call Kelly Bishop at
508-856-2000. For contact information for the WHI
investigators, contact the National Heart, Lung, and
Blood Institute Communications Office at 301-496-4236.
* Ockene JK, Barad DH, Cochrane BB, Larson JC, Gass
M, Wassertheil-Smoller S, Manson JE, Barnabei VM,
Lane DS, Brzyski RG, Rosal MC, Wylie-Rosett J, and
Hays J, “Symptom Experience After Discontinuing
Use of Estrogen Plus Progestin,” Journal
of the American Medical Association. 2005; 294:
183-193.
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