Estrogen Redux

By Christine Gorman

The latest report on estrogen isn't bad news so much as it is incomplete news. Early data from a study involving 27,000 women, called the Women's Health Initiative, suggest that taking estrogen by itself or with the drug progestin slightly increases the risk of suffering blood clots, heart attacks and strokes.

Although the problem seems to disappear after two years of pill taking, researchers were surprised to find any effect at all. On March 31 they sent a letter to all participants in the study outlining what they know so far. What they can't say until the study is completed in another five years is whether this apparent short-term risk is outweighed by any long-term benefits.

What's going on here? Just two weeks ago, preliminary results from another study indicated that starting hormone-replacement therapy may make matters worse for some women with heart disease. Does this mean women should stop taking supplemental estrogen entirely?

Not at all. And certainly not without consulting their doctors. Estrogen (with or without progestin) is still a perfectly reasonable medical treatment for many women with hot flashes or other symptoms of menopause. It can also help prevent or at least minimize osteoporosis.

What hasn't been proved is whether it helps protect the heart. And despite any claims that you may have read on the Internet, there's very little evidence that so-called natural estrogens do either. So until we know for sure what, if anything, estrogen can do for the heart, you should focus on what we know can help preserve good health. First of all, if you smoke, stop. And exercise regularly; even if you're averse to strenuous activity, you can help yourself by taking a brisk 30-min. walk at least four days a week. Find out by a visit to the doctor if you have diabetes, high blood pressure or high cholesterol, and, if so, start treatment. Most important, don't be spooked by interim reports from unfinished studies or by breathless accounts about them.

--By Christine Gorman

For more about the Women's Health Initiative, visit www.nhlbi.nih.gov/whi/hrt.htm You can e-mail Christine at [email protected]