Stopping And Starting

If you're thinking about using hormone replacement therapy to rid yourself of menopause symptoms, it pays to bear in mind that going off the therapy may bring on worse symptoms than ever. This is according to a new study that is part of the very large research initiative known as the Women's Health Initiative (WHI).

Marcia Stefanick, who chairs the WHI's executive committee, says that around a quarter of all women who use HRT (hormone replacement therapy) find they can't stop using it without bringing on severe symptoms. These women may never be able to go off of HRT.

For this study, 10,000 postmenopausal women who had gone into menopause due to surgical removal of the uterus (hysterectomy) were given estrogen therapy or a placebo pill containing no hormones. The women reported on their symptoms prior to beginning these therapies and again after a year of treatment.

Severe Symptoms

Some of the women filled out surveys before and after treatment with one of the two types of pills. One in every three participants reported severe symptoms at the inception of the study while the older women participants had fewer symptoms.

At the end of a year of treatment, those women taking the estrogen pills had half the number of hot flashes, 40% fewer night sweats, and a 20% reduction in vaginal dryness in comparison with those women taking the placebo.  

On the downside, estrogen therapy increased breast tenderness, said the researchers in the report that was published in Menopause.

After the study was over, other issues arose. Some 7% of the participants who had never experienced hot flashes prior to the inception of estrogen replacement therapy began to have them when they ended their therapy at an average of 7 years later. This is as compared to fewer than 2% of those women taking the placebo.

The researchers also observed that the estrogen users experienced more stiffness and joint pain after therapy ended whether or not the women had experienced such symptoms prior to their enrollment in the study.

Breast Cancer

This study was meant to further the conclusions of an earlier WHI study which found that HRT consisting of estrogen and progestin is more detrimental than beneficial when administered to women after menopause who had not undergone hysterectomies. After going off the therapy, the women had 5 times the number of symptom complaints in comparison with those women taking the placebo. The women who had taken the hormones also tended to develop more breast cancer and cardiovascular diseases. Stefanick says that the symptoms of menopause will resolve on their own, without HRT, within 3-5 years for most menopausal women.