Recent medical studies could overturn earlier findings that use of hormone replacement (HR) therapy to treat post-menopausal symptoms could contribute to breast cancer, according to doctors yesterday who noted the benefits of the appropriate use of estrogen-alone therapy.
"When reports of the carcinogenic effect of combined hormone therapy were publicized, the number of women using hormone treatment in Taiwan dropped significantly. As a result, about 20 percent of postmenopausal women in Tai-wan need hormone treatment, but only about 3 percent are receiving it," said Yang Tzay-shing (
Research by the US National Institutes of Health Women's Health Initiative (WHI) in July 2002 indicated that when compared with a control group, the use of estrogen and progestin in HR therapy resulted in eight more instances of breast cancer per 10,000 women a year.
"Despite the conclusions of that study, the WHI recently revealed the results of another study into hormone therapy in which the subjects took estrogen alone. This study showed that there were seven fewer cases of breast cancer in those who took estrogen alone when compared with the placebo-taking control group," said Huang Ko-en (黃國恩), a Chang Gung University professor of obstetrics and gynecology and head of the Center for Menopause and Reproductive Medicine Research.
While Huang said that estrogen-alone therapy could reduce the risk of breast cancer, the NHI had concluded in its report that despite the statistical decrease in the number of breast-cancer patients in the study, the medical relationship remained "uncertain."
The April study also concluded that the use of estrogen-alone therapy increased the risk of stroke, with 12 more cases of stroke in the HR therapy group than in the control group. There was also an increase in the incidence of venous thrombosis, or blood clots in one of the deep veins of the legs, in the women taking estrogen. On the other hand, fewer hip and bone fractures were diagnosed in those who took estrogen alone.
In addition, the later study recorded no significant difference in the risk of coronary heart disease in relation to hormone usage.
However, the doctors questioned the applicability of the study results to women in this country because Asian women were a very small percentage of participants -- 75 percent were white, 15 percent black and 8 percent Hispanic. Most of the women were also overweight, according to a WHI statement.
"One of the problems with the study is that the participants were on average much older than the women receiving hormone therapy in Taiwan. The average age of the women in the study was 63," Huang said.
Yang also pointed out that it is generally accepted that Asian women are not at as great of risk of stroke as white women are.
"Early is good ... The benefits of estrogen will outweigh the drawbacks if hormone therapy is begun shortly after menopause," Yang said.
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