CHICAGO Younger women may be able to safely take hormone replacement therapy to treat menopause symptoms based on a new analysis of a big U.S. study that had raised alarms about health risks and driven down sales of treatment drugs, according to a report released on Tuesday.
A second look at the highly publicized 2002 study called the Women's Health Initiative, or WHI, suggests that women who begin hormone replacement therapy within 10 years of menopause may have less risk of heart attack than women who start hormone therapy later.
The results are "somewhat reassuring," said Dr. Jacques Rossouw, lead author of the study, which appears in this week's Journal of the American Medical Association.
Rossouw, in a telephone interview, said hormone replacement therapy, known as HRT, still increases the risk of breast cancer and stroke in younger women but the absolute risk for that age group is low.
"Check your blood pressure and have regular mammograms. If you do those things, HRT is a reasonable option in women with severe menopause symptoms," said Rossouw, who is chief of the Women's Health Initiative branch of the National Heart, Lung and Blood Institute.
The original WHI study was designed to find out whether hormones protected menopausal women from heart attacks, a view that was widely held in the 1990s. Instead, the study found the therapy increased the risk of blood clots, heart attacks and breast cancer.
That led millions of women to abandon HRT, leaving them to face the hot flashes, sleepless nights and other menopause symptoms with few treatment alternatives.
Sales of Wyeth's Premarin and its other female hormone replacement drug, Prempro, fell sharply after the release of the 2002 study.
Since then, however, the pendulum has been swinging back toward selective use of HRT as studies emerge suggesting the treatment may not be so dangerous for women just entering menopause.
The WHI study involved women with an average age of 63, long past menopause, which typically occurs between the ages of 45 and 55.
The new analysis combined data from two WHI trials of estrogen plus progestin, the 2002 study, and estrogen alone, a 2004 study. They looked at differences in hormone therapy effects in three age categories -- women in their 50s, 60s and 70s -- as well as by distance from menopause.
That analysis suggests that the health consequences of hormone therapy may vary. "It brings the picture into sharper focus," Rossouw said.
The study also revealed that older women on hormone therapy who are at increased risk for heart attack tend to be those who also have hot flashes and night sweats. These women also were more likely to have high blood pressure or high blood cholesterol.
It found a trend toward protecting younger women from heart attack, but that was not statistically significant.
"Most women require hormone therapy for only a few years to alleviate their symptoms and this analysis indicates that hormone therapy is generally safe for healthy women," Dr. Robert Rebar, executive director of the American Society for Reproductive Medicine, said in a statement.
"It's reassuring information for ... newly menopausal women who'd like to take hormone therapy," said Dr. Joseph Camardo, head of medical affairs at Wyeth.
Rossouw said it may be too late for women who abandoned HRT after the 2002 study to resume therapy.