Many forsaking hormone therapy

BETHESDA, Md. -- Women have quit hormone therapy in droves since a major study in July declared the pills riskier for their hearts and breasts than once thought.

Seeking to ease confusion over just who should take hormones and for how long, federal scientists opened a long-awaited meeting Wednesday.

" 'What should I do?' is the most common question you hear from patients," said Dr. Elias Zerhouni, director of the National Institutes of Health.

The main message from the latest research is that women shouldn't start hormone therapy in hopes of stopping age-related diseases -- one big reason that estrogen-and-progestin pills were prescribed to some 6-million U.S. women, said the scientists who conducted NIH's Women's Health Initiative, the biggest hormone study ever done.

"We can't take a pill for the rest of our life to make us young again. Disappointing but true," said co-investigator Susan Hendrix of Wayne State University.

The WHI study that set off the controversy found that for every 10,000 women who swallow estrogen-and-progestin pills, each year there will be eight more breast cancers, seven more heart attacks, eight more strokes and eight more life-threatening blood clots in the lungs than women not taking the pills would suffer.

But that doesn't tell hormones' whole story:

Researchers are continuing to study if using estrogen alone -- possible only for women who have had hysterectomies, as estrogen alone causes uterine cancer -- is safe, and whether hormones prevent Alzheimer's disease.

No one knows if stopping estrogen-and-progestin pills makes their risk go away. However, a recent NIH study found only current users of estrogen-and-progestin pills appeared at increased risk of getting breast cancer, said Dr. Robert Spirtas, NIH's reproductive health chief.

Many physicians' main complaint is the July study didn't consider that hormones are the undisputed best treatment for hot flashes and other symptoms of menopause. Consequently, no one can yet say who are the best candidates to use hormones for that reason.

Still, many women have abandoned hormones. Sales of Preempro are down 40 percent, Wyeth says, and 632,000 fewer prescriptions for all estrogen-progestin brands were filled the month after the study was announced than the 2.2-million filled the month before the bad headlines, according to IMS Health, a company that tracks drug sales. (Researchers insist there's no reason one brand would be riskier than another.)

Estrogen-only sales are down, too, by 15 percent for the top brand, Premarin, Wyeth said. For all estrogen brands, 426,000 fewer prescriptions were filled in August than the 5.5-million filled in June, says IMS Health.

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