HRT puts thousands at risk

UP to 65,000 Irish women on hormone replacement therapy (HRT) are putting their health at risk, medical experts warned yesterday.

A five-year study has shown that long-term use of oestrogen and progestin increased women’s risk of a stroke by 41%, a heart attack by 29% and breast cancer by up to 26%.

The breast cancer finding was the decisive factor in ending the study three years earlier than planned, according to scientists at the US-based National Institute of Health (NIH).

Up to 10% of Irish women aged over 45 years of age use HRT. Though the treatment is used to reduce the risk of bowel cancer, heart disease and osteoporosis brought on by hormone changes after menopause, NIH experts said the dangers outweigh the benefits.

Yesterday the director of Women’s Health at the Irish College of General Practitioners, Dr Ailis Ní Riain, said Irish women should consult their doctors about the risk and benefits of HRT.

Women use HRT for short-term relief of hot flashes and other menopausal symptoms. And traditionally doctors have believed that long-term use would prevent heart disease and brittle bones and generally keep women healthier longer.

However, experts stopped their study of 16,600 women, aged 50 to 79, and advised others who used the oestrogen/progestin combination to ask their doctors if they should give up the treatment.

Acting director of the NIH’s Women’s Health Initiative, Dr Jacques Rossouw, said HRT might have a role to play in preventing osteoporosis in some women, but for promoting overall health it was not a good idea.

The NIH study shows that for every 10,000 women who take the oestrogen/progestin combination there will be eight more breast cancers, eight more strokes and seven more heart attacks.

“We recommend that clinicians stop prescribing this combination for long-term use,” said Dr Suzanne Fletcher of Harvard Medical School in the Journal of the American Medical Association.

“Risks from the drug add up over time,” she said. “The whole purpose of healthy women taking long-term oestrogen/progestin therapy is to preserve health and prevent disease. The results of this study provide strong evidence that the opposite is happening for important aspects of women’s health, even if the absolute risk is low.”

A total of 16,608 post-menopausal women took part in the trial at 40 US centres. Half were given a daily tablet containing a combination of the female hormones oestrogen and progestin. The rest took a placebo pill.

Millions of women all over the world take the oestrogen/progestin combination of HRT, which combines two hormones in a single pill.