text_1: Study: Safe hormone therapy after hysterectomy
text_2: This story provides a brief overview of the results of the Estrogen-Alone study, which was a large, randomized, blinded trial and part of the Women’s Health Initiative study of hormone replacement therapy (HRT). The story accurately notes that estrogen-alone therapy is only for postmenopausal women who have had a hysterectomy. The story provides some balance on the risks and benefits of taking estrogen alone to relieve symptoms of menopause, and there is caution that it is not right for certain women. There is discussion of some of the established benefits of HRT, such as relieving hot flashes and helping to prevent osteoporosis. However, there is no quantitative data from the study on how great a benefit HRT would provide. For example, in the estrogen alone study, there were only 6 fewer hip fractures (11 cases in estrogen alone and 17 cases in placebo group) out of tens of thousands of women enrolled. There is no discussion of other medications which are effectively used to prevent osteoporosis and have fewer health risks. The most erroneous portion of the story is the claim that “women can take this form of HRT with worrying about breast cancer.” It is true that there were fewer cases of breast cancer in the estrogen alone group: 28 per 10,000 in the estrogen group vs. 34 per 10,000 in the placebo group, and the difference was not statistically significant. However, there were more abnormal mammograms that required follow-up and 33% more breast biopsies in the estrogen alone group (747 vs. 549), which does not necessarily mean more breast cancer, but can signal changes in breast cells and tissue. Also, women at a higher risk of developing breast cancer in the estrogen-alone group had larger tumors that spread to the lymph nodes, which can mean a poorer prognosis and more breast cancer treatment. Lastly, there is no discussion that menopause is a natural part of aging and not a condition which necessitates medical intervention. Unless symptoms are very bothersome, many women do not need to take hormone therapy medications to ease symptoms common in menopause such as hot flashes, cold sweats and vaginal dryness and discomfort. The report does not talk about less invasive alternative treatments for relieving symptoms of menopause such as exercise, vaginal creams, and wearing loose, cool clothing to prevent discomfort from hot flashes and cold sweats.