Hormone therapy for menopause is one of the most divisive subjects in medicine, hailed by some as a boon to women’s comfort and well-being, vilified by others as a threat to health.
A new analysis finds truth somewhere in the middle, reaffirming previous warnings that the drugs have more risks than benefits for most women — but also stating that the harms are low early in menopause and that hormones are “appropriate for symptom management in some women.”
Dr. JoAnn E. Manson, author of the analysis and a professor of medicine at Harvard’s medical school, said that the findings “should not be used as a basis for denying women treatment if they’re in early menopause and have significant distressing symptoms.”
The new report, published in the Journal of the American Medical Association, is based on long-term data from the Women’s Health Initiative, a large, federally funded study that turned medical thinking on its head a decade ago by uncovering the risks of hormones.
The report is the first to include extended follow-up data from the original health initiative study, an additional six to eight years’ worth of information on about 80 percent of the original participants, who took a combination of estrogen and progesterone, estrogen alone or placebos for several years.
Exercise might work as well as drugs
Exercise might work just as well or better than drugs for people with coronary heart disease or recovering from a stroke, according to a review of evidence published last week..
The scientists looked at the outcomes of 305 previous trials with 339,274 participants to try to determine whether physical activity was as effective as drugs at preventing death among people with four conditions: coronary heart disease, rehabilitation from stroke, treatment for heart failure and prevention of diabetes. There was no difference between exercise and drug interventions for the people with coronary heart disease and for the prevention of diabetes. Exercise was more effective than drugs for recovery from stroke. And drugs, specifically diuretics, were more effective for treatment of heart failure.
Exercise should be considered as “viable alternative to, or alongside, drug therapy,” the researchers said.
The exercise in the research generally took place in structured rehabilitation programs to which patients had been referred by their doctors, said Huseyin Naci, a study author, who is a fellow at the Harvard Medical School and researcher at the London School of Economics. “The results of our study by no means imply that people should stop taking their medications, especially without consulting their doctors.”