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July 10, 2002
We have seen the recent newspaper publications of the recent
study on the use of PremPro in menopause. In some ways, this information is new
and contradictory to what we have believed, and in some ways, it rather agrees
with what we have already known.
In summary, this data that has been recently released is
still too little and too early for us to base a sudden change in our
recommendations for hormone replacement therapy at this time. Our current
recommendations are based upon decades of data and research. It is possible
that our position may change in the future, but we want to base any change on a
great deal of evidence, at least as good as the evidence that has driven our
current recommendations.
Keep in mind these points:
- First, this study ONLY looked at PremPro, and its results
should not necessarily be carried over to other hormone replacement drugs or
products.
- Second, remember that, while huge newspaper headlines
make statements that seem to be factual and straightforward, the 16,000
patients in this study still only represent a relatively small amount of
additional data to what has been collected in hundreds of studies over the past
several decades. There are many variables that can make what seem to be hard
and fast results lose their validity in short order, and we wait for our
professional community to fully assess the data.
- Third, this new data suggests that PremPro increases the
risk of cardiovascular disease and breast cancer. In one way, this agrees with
previous studies. It has been shown in the past 10 years that PremPro can lead
to an increase in cardiovascular events in some women who already have
pre-existing heart disease, and hormone replacement can also possibly be
associated with a tiny increase in breast cancer risk. The breast cancer risk
has been so small, it has only been found in a few studies, and most studies
with hormone replacement show no increased risk. Nevertheless, it is nothing
new to suppose that hormones can increase your breast cancer risk slightly. On
the other hand, women who develop breast cancer were shown in a study to have
better survival if they are on hormone replacement. Regular mammograms and
monthly self exam will help to reduce the mortality caused by breast cancer,
too.
- Fourth, this new study does not in any way challenge the
well-established fact that hormones do indeed help prevent osteoporosis. Hip
and spine fractures due to osteoporosis result in the number three cause of
death in women over 65.
- Finally, we understand your concern, and in some ways,
these new results concern us, too. If you have been been using hormones for 10
years or more, you would probably not lose any benefits by stopping your
hormones by taking them every other day for a couple of weeks then stopping
altogether. If you still have menopausal symptoms, you can restart your
hormones and attempt to come off again in six months. For bone protection,
there are some other products besides hormones available, but they do not
suppress menopausal symptoms and do not provide the "brain" benefit of hormones
for reducing risk of Alzheimer's disease, among other possible benefits.
Given what we now know, only you can make the final
decision. For our part, we stand by our current recommendations and await
further evaluation of this new data before making any changes.
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