By Molly M. Ginty
Sunday, July 10, 2005
Three years after a study blasted confidence in the leading treatment for menopause, an estimated one third of the 18 million women who used to be on hormone therapy are trying other remedies such as the vaginal ring, non-hormonal drugs and health foods.
(WOMENSENEWS)--The news rattled Marilyn Kentz even more than the hot flashes and mood swings she suffered.
"In July 2002, when the Women's Health Initiative found the drugs I was taking for menopause could increase the risk of heart attack, I was not only shocked, but terrified," says Kentz, 57, a writer in Los Angeles. "My father died of heart disease at the age of 42 and, determined to avoid his fate; I quit hormone therapy as soon as I heard about the study's results."
Without her daily doses of synthetic estrogen and progestin, hot flashes kept her up nights and mood swings left her weeping inconsolably. "My symptoms were so bad that I decided to go back on medication after a six-month break," says Kentz.
Health advocates say one third of the former users of hormone therapy--pharmaceutical companies put that total figure at over 18 million--are likely going without treatment or trying alternative remedies.
Kentz, for instance, is now using the Femring, a vaginal ring that releases estrogen. Taken along with progestin pills, this regimen is helping her feel much better.
Hormone therapy had been offered to tens of millions of U.S. women entering menopause, the stage during which women stop menstruating and estrogen levels drop. First prescribed in the late 1960s, these drugs--either an estrogen-progestin combination or an estrogen-only version for women who had had hysterectomies--were touted as the "cure" for menopause and as protective against heart disease and breast cancer.
Then came July 9, 2002, and the publication of an article in the Journal of the American Medical Association by leaders of the federally-funded Women's Health Initiative study, conducted by the Bethesda-based National Institutes of Health.
In that landmark article, researchers with the study (which was launched in 1991 and enrolled 161,000 women) reported that hormone therapy can lead to small increases in breast cancer, heart attacks, strokes and blood clots and that these risks outweighed the drugs' benefits of slight protection against colorectal cancer and bone fractures.
In 2003, the year after the study, sales of synthetic hormones plummeted 38 percent and the number of women on hormone therapy plunged from 18.5 to 7.6 million.
Now many women, like Kentz, are using the vaginal ring. Others are taking non-hormonal drugs that prevent hot flashes and bone loss or low-dose versions of hormone therapy. Selective serotonin reuptake inhibitors (anti-depressants such as Effexor) ease hot flashes. Biophosphonates (such as Fosamax and Actonel) and selective estrogen receptor modulators (such as Evista) work to maintain bone density.
"Bioidentical" hormones are also in use, marketed under trade names such as Prometrium and TriEst.
"While regular hormone therapy uses synthetic hor