http://www.boston.com/dailynews/156/nation/Study_finds_low_hormone_doses_:.shtml

Study finds low hormone doses for menopause as effective as high doses

By Linda A. Johnson, Associated Press, 6/5/2001 01:01

TRENTON, N.J. (AP) A major study funded by the top seller of a hormone therapy for menopause finds low doses of estrogen and progestin worked as well as higher doses, with fewer side effects.

''This is an important advance'' as women and doctors increasingly debate the benefits of hormone replacement therapy, said Dr. Margery Gass, director of the Menopause and Osteoporosis Center at University Hospital in Cincinnati.

''Now we finally have some good evidence that lower doses can be satisfactory for many people,'' she said.

Dr. Wulf Utian, one of the principal investigators, predicted on Monday that low-dose pills now will be given to many women who are just starting hormone therapy or who are bothered by side effects, such as irregular bleeding and breast tenderness.

Women taking hormones without problems ''will do just as well to stay on what they're currently taking,'' added Utian, executive director of the North American Menopause Society.

Roughly a third of American women 50 and older take hormones to control menopause symptoms such as hot flashes, or to cut their risk of osteoporosis.

Two reports on the two-year Women's Health, Osteoporosis, Progestin, Estrogen (Women's HOPE) study appear in the June issue of the journal Fertility and Sterility.

The 57-site study included 2,673 healthy, postmenopausal women who still had their uterus. Some received pills containing the most common estrogen dosage, 0.625 mg a day, with or without 2.5 mg of progestin. Other women were given combinations of progestin and two lower estrogen doses.

One report states that combining 1.5 mg of progestin with 0.45 mg or 0.3 mg of estrogen daily was as effective as higher doses in reducing hot flashes and preventing thinning of the vaginal lining, which causes infections and painful intercourse for many older women.

The other report shows the same low-dose combinations worked about as well as higher doses in preventing ''breakthrough'' bleeding, the main reason many women stop hormone therapy.

Worries that the therapy can increase the risk of breast cancer also may make low doses more appealing.

The research was funded by Wyeth-Ayerst Research, part of American Home Products.

The company makes Premarin, which accounted for about two-thirds of the $1.7 billion in hormone replacement medications sold last year, according to health-care data company IMS Health.

There are currently no low-dose forms of popular hormone pills combining estrogen and progestin, but American Home hopes to sell a version of its Prempro, containing 0.45 mg of estrogen and 1.5 mg of progestin, by year's end.

''It's really good to have the options,'' said Gass, who has been giving patients low doses for a decade, although that required taking two different pills.

-- Anonymous, June 05, 2001

Answers

I hope they get this stuff figured out in the next ten years. . .that's when I'll need it.

-- Anonymous, June 05, 2001

Meemur, I haven't quite reached menopause (according to some blood test), but going back on a low-dose pill, after maybe 23 years, was a godsend. My monthlies were becoming increasingly out of control. Now I get the corrective benefits without any of the side effects I remember from an earlier incarnation.

-- Anonymous, June 05, 2001

Due to my age I should be in menopause at any time, but I use a soy supplement. The only thing it doesn't help is my brain fog and I am working on that in other ways.

After going through the 60's when women were experimented on with birth control pills I don't trust drug companies in this area at all. I had been put on them when I was 18 and newly married - boy was I a disaster - talk about PMS - I put Roseann to shame. Then after I went off of them, I didn't ovulate for over a year. My doctor told me to never go on them again if I wanted to have children. I know that the dosages in the 60's were many times what they use today, but I still don't trust the pharmacueicals.

-- Anonymous, June 05, 2001

beckie,

In my case I needed something quick, because I was starting to feel quite violent, let alone extremely depressed and otherwise incapacitated. What I wouldn't consider were "solutions" like Prozac. St. John's Wort and SAM-e, which I consider safe enough, had no impact whatsoever.

I went off the pill years ago because I didn't trust it at the time for the reasons you have mentioned. For the moment, I can't afford to experiment with other solutions. Should officially reach menopause in a few years, and I'll re-evaluate it then. Meanwhile, the change has been miraculous.

-- Anonymous, June 05, 2001

Brooks, are you taking the synthetic stuff? The real estrogen comes from continually pregnant mares who are kept much like veal calves.

I can't remember the last time I had a period--maybe two years ago? Anyway, I've been experiencing menopausal symptoms for over ten years, maybe as long as fifteen. Every woman I've ever spoken to has told me she experienced symptoms long before the blood test said she was menopausal. Even with HRT, I still get hot flashes occasionally and my hair is getting thin! My skin is beginning to get that coarseness associated with older women and varicose veins are starting to appear. I have a couple of places on my chin I have to watch, otherwise a hair starts to grow--and grow--and grow! Cher must spend 12 hours a day (at least) keeping all this stuff at bay. God, I'm SO glad I'm not famous and can grow old gracefully. (It's a relative term; the ballet training did little good.)

-- Anonymous, June 05, 2001

OG, Cher's Full Time Job is Staying Young. The rest of us have Lives.

Brooks, I'm going to keep an eye on those lose-dose studies. I'm okay for now and also had some bad experiences with the pill in the early 70s, so I'm not looking forward to doing more chemicals, but if it becomes a quality of life issue, I'm going to explore all of the options.

-- Anonymous, June 05, 2001