[Mb-civic] CBC News - MENOPAUSE SYMPTOMS BOUNCE BACK AFTER HRT STOPS

Wed Jul 13 17:09:06 PDT 2005

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MENOPAUSE SYMPTOMS BOUNCE BACK AFTER HRT STOPS
WebPosted Tue Jul 12 18:23:26 2005

---More than half of women studied who stopped taking hormone
replacement therapy saw their menopausal symptoms return, but lifestyle
changes may help.

In 2002, the Women's Health Initiative trial was stopped early because
researchers discovered combined estrogen and progestin therapy increased
women's risk of breast cancer, heart disease and stroke, compared to
those taking a placebo.

Official guidelines now recommend women take hormone therapy for
menopausal symptoms for the shortest time possible and at the
lowest dose.

The abrupt conclusion to the trial gave doctors a chance to look at
the effects of ending therapy in more than 8,000 women with an average
age of 69.

Among women who reported problems such as hot flashes or night sweats at
the beginning of the study, 56 per cent on HRT reported the symptoms
returned, compared to 21 per cent for those taking a placebo.

Four out of five women who reported trying non-pharmaceutical strategies
said these provided some relief. Drinking more fluids and starting or
increasing exercise were reported by more than 20 per cent of women in
each treatment group described in the July 13 issue of the Journal of the
American Medical Association.

Judith Ockene of the University of Massachusetts Medical School and her
co-authors recommend further tests on the effectiveness of such lifestyle
strategies that carry minimal risk.

The high frequency of symptoms reported may also be a result of stopping
hormone or placebo therapy so abruptly, noted Dr. Diana Petitti of Kaiser
Permanente Southern California.

"When it is time to consider discontinuing hormone therapy, gradual
tapering off the dose would be a logical clinical strategy arising from
these new observations," Petitti wrote in a journal commentary.

The data on "placebo withdrawal effect" and relief from lifestyle changes
also raise questions about the physiological basis of some symptoms
linked to menopause, Petitti said.

Little is known about distinguishing what could be symptoms of ovarian
aging, such as night sweats or vaginal dryness, compared to symptoms of
aging in general for both sexes, including aches and tiredness.