April 2, 2009
Nothing illustrates the problem with medication better than the debacle related to hormone replace therapy (HRT). In the 1990s, many doctors began prescribing HRT to help prevent heart disease in women. A Harvard study of about 46,000 female nurses had found that those who had taken HRT had a lower incidence of heart disease by up to 50 percent. However, when that study was more fully investigated, it turned out that the women with lower rates of heart disease were actually women who were healthier in general. Compared to the group who were supposed to have a greater incidence of heart disease, they were wealthier, more likely to exercise, and had better diets; fewer of them had diabetes, and they smoked less. The women who didn’t take HRT were more likely to have diabetes, smoked, were poorer, and didn’t visit their doctors. Also not reported in the study was the fact that the women who took HRT had a 50 percent increase in strokes. This, then, was a flawed, biased study.
“The rationale for giving HRT to postmenopausal women was that when you arrive at menopause, your risk of getting heart disease or stroke will skyrocket and, therefore, you need protection,” says Dr. Sherrill Sellman, a naturopath, psychotherapist, and author of the best-selling book Hormone Heresy. But, she says, studies from reputable researchers showed that this was a myth. There was no rapid increase of heart disease in postmenopausal women. There was simply a rise in heart disease as women move on in life in general. The doctors who pushed HRT as a preventive for women’s heart disease seemed not to take into account the fact that men also have a higher incidence of heart disease as they age.
Studies began to come in challenging the theory that hormone replacement therapy was beneficial to the heart. A study published in 2001 found that post-menopausal women with heart problems who took hormone supplements for less than one year actually had a greater risk of another heart attack or death from heart disease than women who were not on HRT. An earlier study, sponsored by Ayerst, the company that manufactured the number-one replacement estrogen, Premarin, yielded similar results. Dr. Sellman explains, “They gave half the women hormone replacement therapy and the other half a placebo. After five years, they discovered that in the first year of treatment, the women taking the HRT had a 50 percent increase in heart attacks. Over the five years, the risk decreased. The conclusion was that women who already had heart conditions got no overall benefit from HRT. But this glossed over the horrible fact that HRT increased heart problems the first year. What was more, women taking it had three times as many blood clots in the legs than women taking the placebo. There was also an increase in gallbladder disease.”
In 2001, the American Heart Association finally took heed of the growing scientific evidence and shifted its stance, advising against the use of hormone replacement therapy to prevent heart disease in women. And, in 2003, a major government trial, known as the Women’s Health Initiative (WHI), definitively linked the long-term use of combined estrogen and progestin as menopausal hormone therapy to an increased risk of heart disease, as well as stroke and breast cancer. As described in a 2007 press release issued by the National Institutes of Health, “both the estrogen plus progestin and estrogen-alone trials of the WHI were stopped early because of increased health risks and the failure to prevent heart disease. Specifically, the estrogen plus progestin trial was stopped after 5.6 years because of an increased risk of breast cancer and because overall risks, including increased risks for heart attack, stroke, and blood clots, outnumbered benefits. The estrogen-alone study was stopped after 6.8 years because of an increased risk of stroke and no reduction in risk of CHD [coronary heart disease]. The estrogen-alone study also found an increased risk of blood clots.” The findings suggested that risk due to hormones may differ depending on age or years since menopause.
The solution here is to work with a complementary medical physician until your heart health is restored. In some cases, medication may be needed long term, even for a lifetime, but no one can fail to benefit from improving lifestyle and diet.