Relief that may be too risky.(hormone therapy)

For 15 years Sidney Constien took hormone therapy for symptoms of menopause. "I kept asking the doctor, 'How long do I have to take this?' He kept saying, 'How long do you want to live?' " Bolstered by the wide-spread belief that hormone therapy prevented heart disease in postmenopausal women, Constien stayed on it. Then, in the spring of 2002, she was diagnosed with breast cancer. A few months later the U.S. National Institutes of Health halted its study of estrogen-plus- progesterone therapy because of evidence that it increased the risk of strokes, blood clots, heart attacks and--most shocking to Constien-- breast cancer. Although she's cancer-free after lumpectomy and radiation, Constien, now 66, has a new mission. "I want to get the word out because I have friends who are still on it," she says. "They think it's keeping them young."

No problem getting the word out this year. It seemed as if every month researchers released more bad news. New data showed that hormone therapy increased the risk of dementia, and that women who took hormones were more likely to have more advanced breast cancers. Research also showed that the heart-disease risk increased 80 percent during the first year of use.

The scary headlines are bewildering to a generation of women who grew up thinking hormone therapy was virtually a fountain of youth. Many simply threw out their pills. In the four months after the July 2002 publication of the NIH's Women's Health Initiative study, about a third of women on estrogen-plus-progesterone products stopped taking them, according to research by a company called Express Scripts, which studies prescription data. A year later only 15 percent of the quitters had started taking hormones again. The decline continued this year. In March, Express Scripts found that an additional 26 percent of women who had originally decided to stick with hormone therapy had later dropped it. And everybody wondered: how could the doctors get it so wrong?

The simple answer is that doctors originally decided hormone therapy was safe because they'd seen positive results in their patients who began treatment at the start of menopause. Based on observational studies of these first patients, doctors began to think in the late 1980s that besides easing hot flashes, hormone therapy prevented all kinds of chronic diseases, says Isaac Schiff, chief of obstetrics and gynecology at Massachusetts General Hospital in ...