Doctors Meet on Hormone News
Associated Press
By LINDSEY TANNER AP Medical Writer
Thursday, October 3, 2002

Besieged by patients anxious and confused over recent bad news about hormone supplements, doctors flocked to a meeting of experts in Chicago to get answers for themselves.

"It affected us all, to some degree, across the board. We're getting a lot of phone calls,'' said Dr. Sylvia Garwin, an obstetrician-gynecologist from Herrin, Illinois. "Many patients on hormones are quitting, trying unproven herbal remedies and suffering through hot flashes and night sweats, unsure of what to do next," Garwin said at the annual meeting of the North American Menopause Society. "I'd like to know what other doctors are telling their patients,'' she said.

The Chicago meeting is the first formal gathering of specialists since it was announced in July that a landmark government study had found evidence linking estrogen-progestin supplements with breast cancer and heart disease. The nonprofit society represents more than 2,000 doctors, nurses and other health-care providers. More than 1,500 registered for the meeting, a higher-than-normal response organizers attributed to concern over the study results.

The National Institutes of Health study found a 26 percent increased risk of breast cancer and an even higher risk of strokes and heart attacks among hormone users despite the once-widespread belief that the supplements could help protect the heart.

"Not only the public, but also the health providers were thrown into a sort of turmoil,'' said Dr. Wulf Utian, the society's executive director. "There have been significant levels of debate, argument, discussion, and there's still a level of real uncertainty of what this all means.''

Many of those at the meeting said they think that the results were sensationalized and that hormones - taken by millions to reduce symptoms and prevent bone loss - are still appropriate for some women.

The menopause society agreed in issuing its new hormone recommendations, noting that the study involved women ages 50 to 79 and only one type of hormone supplement - estrogen-progestin pills.

The recommendations note that the study did not answer whether similar results would be found in younger women in "perimenopause,'' the period leading up to the last menstrual period when symptoms often are the most severe. Nor did it address other types of hormone treatment, including lower doses, creams and skin patches.

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The recommendations, released Thursday, say hormone supplements should be limited primarily to treating symptoms such as hot flashes and vaginal dryness. Lower-than-standard doses should be tried, for the shortest possible time.

The society also said hormones should not be used to help prevent heart disease, and alternative medication should be considered for prevention of osteoporosis, or thinning bones.

The focus of the three-day meeting is on helping menopausal women maintain a good quality of life with or without hormone therapy. The standard medical mantra - eat healthy food, get plenty of exercise and maintain a normal weight - was touted at several sessions as a no-risk remedy.

Research presented at the meeting considered over-the-counter items billed as natural hormone alternatives, including soy-based products and herbal remedies like black cohosh, which is said to reduce hot flashes.

One study found evidence that soy-based tablets can help improve memory. Another suggested black cohosh extracts do not contain breast cancer-promoting products.

Most such research is preliminary, but many health providers say patient demand is forcing them to consider the alternatives.

Sanna Conoley, a nurse from Austin, Texas, said many of her patients scared by the hormone study are trying herbal products, with varying degrees of success. She said she warns patients that ``just because it's an herb doesn't mean it's safe.''

On the Net:
Menopause Society: http://www.menopause.org
NIH: http://www.nlm.nih.gov
Copyright 2002 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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