Hormone therapy: The risk-benefit tightrope.(Women's Health Initiative)

Publication: Harvard Health Letter

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COPYRIGHT 2007 Copyright by President and Fellows of Harvard College. All Rights Reserved

Women must balance heart disease protection and breast cancer risk.

It was a shock several years ago when results from a large, government-funded study called the Women's Health Initiative (WHI) showed that postmenopausal women who took hormones were more likely to have heart problems than those who didn't. Previous research had pointed to both risks and benefits from hormone therapy. The risks? Stroke, blood clots in the veins that could potentially travel to the lungs (pulmonary emboli), and most of all, breast cancer -- all were more likely with hormone therapy.

But on the benefit side of the equation were a lower risk for colon cancer, protection against broken bones, relief from a variety of postmenopausal symptoms like hot flashes and night sweats -- and protection against heart disease. And since heart disease is by far the most common cause of both death and disability in women, protection against heart disease was important.

But the 2002 WHI results threw the risk-benefit balancing act out of alignment. It seemed that hormone therapy increased the risk for both the most feared disease, breast cancer, and...

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