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A new website launched by Wyeth called knowmenopause.com - Hormone Replacement Therapy HRT

June 2nd 2006

A new website launched by Wyeth called knowmenopause.com - Hormone Replacement Therapy HRT

Health

Several years ago, Wyeth developed a wesbite called menopausehealth.com as part of an "educational" campaign for women entitled VITALITY: HEALTH AND WELLNESS FOR MIDLIFE AND BEYOND. It piggy-backed off of the ubiquitous TV and print ads featuring Lauren Hutton touting hormone replacement as a longterm therapy for feeling and looking good and for maintaining health. The wesbite didn't outright state that estrogen prevented all of these diseases, just that the evidence was mounting that estrogen LOSS caused all of them and that the small increased risk of breast cancer associated with HRT (which paid breast specialist Michele Blackwood said might not even exist) would, at worst, be mitigated by the reductions in heart disease, colon cancer, Alzheimer's, bone loss, tooth loss, you name it!

 

The NEW wesbite (knowmenopause.com) comes on the heels of the results of the WHI (Women's Health Initiative) which have been reported periodically over the last 4 years. Wyeth fortunately has toned it down big time and makes no claims, theoretical or disproven, for disease prevention, other than bone loss. They do touch on the WHI results but state that if symptoms are intolerable, hormone therapy is a good idea, when of course used in low doses for short durations of time.

While it is certainly encouraging to see the pharmaceutical giant acting responsibly and not inundating women with confusing spin and theories about prevention, there is still something bothersome about this new approach. For one, there is a live, interactive session with a panel of esteemed gynecologists who talk about symptoms, specific therapy options, and actual risks (a good thing), but it just so happens that it was mainly gynecologists in the past (specifically Donnica Moore MD who's now part of this new web-based Wyeth campaign) who really "took over" so to speak and started assuming multiple roles as CARDIOLOGIST, NEUROLOGIST, or ONCOLOGIST to their patients, saying hormones help the heart and brain and are unlikely to contribute to cancer risk.

 

Although women shouldn't be unduly worried about potential risks, it's still hard to place a lot of trust in a drug manufacturer and its paid panel of physicians who, in the not-too-distant past, really bent the truth and emphasized the PRACTICE of medicine (drug prescribing) before the PROOF of its real effects was in.

So who's likely to need hormone therapy? It depends on the individual. If women are bothered by symptoms and truly cannot or do not want to tough it out, nothing holds a candle to hormones' benefits for symptom relief. Yet is there ever a time when estrogen should be a long term option? Possibly, but only for certain women, such as those who have had surgical menopause at an early age (such women should consider low dose estrogen until what would be an average age of menopause, say 48 to 52).

 

These women on estrogen ONLY therapy can probably put their mind at ease in terms of breast cancer, since estrogen without progestin seems to take a good 15 years to have meaningful impact on risk. Unfortunately, there is still a lot of guessing involved. Despite the crossfire of opinions and theories about actual risk, hard data show that estrogen therapy DOES pose a VERY slight heart attack risk within the first 2 years of use (a 16%-25% increase), although this is significantly smaller than the early increased risk seen with combined estrogen/progestin, which nearly doubles in the first year.

Blood clots and stroke are also a consideration, the latter which seems to remain elevated as long as a woman takes hormones. Dementia or mild cognitive impairment is a significant risk for women over 65; the likelihood of this in younger women is unknown (WHI will be releasing information this summer on a series CT scans and MRIs of the brains of women taking active hormones vs. placebo). If a woman is not bothered by her symptoms, just plain doesn't have them, has risk factors for heart disease or cancer, or is overly concerned about the actual risks of hormones, she should strongly consider steering clear of them. Women should not turn to estrogen as a cosmeceutical; it MIGHT have some benefit in preventing skin dryness, but will not have an impact in terms of wrinkles, sun damage, or the effects of smoking, nor does it have an effect on hair thinning.

All in all, though some specialists claim that the risks of hormone therapy pertain only to progestin, this is quite inaccurate. Both estrogen alone and combined therapy seem to pose equal risk in terms of stroke and cognitive decline; estrogen alone poses an early small heart attack and blood clot risk - for combined therapy, the risk is even higher and remains elevated for 6 years, which was actually the entire duration of WHI 1's evaluation of Prempro. As for breast cancer, combined estrogen/progestin has been proven conclusively to increase risk, and estrogen alone probably poses a small increased risk as well but only among REALLY LONG TERM users.

Since women continue to get browbeaten by conflicting reports, a lot of it coming from HRT proponents trying to lead them down the same road that brought them to a bleak dead end, it may be a long time before the dust settles. Experts will debate till they're blue in the face, but women need to know what to do now. The good thing is that a large number have already made up their minds, which hasn't boded well for Wyeth's profits. And although the company may, for now, be taking an extremely conservative approach to its class of hormone drugs, it is essential that women remain informed and be cautious about supposedly earth-shattering "positive" information that might fuel Wyeth's (currently sundered) quest to have its female consumers visiting their local drug stores every month with a lifetime prescription for hormone therapy.

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Jonathan Raymond
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Copyright 2005 Best Syndication                   Last Updated Saturday, July 10, 2010 09:46 PM