Many women and health experts continue to struggle with the turnaround in attitude toward hormone therapy in the wake of the Women’s Health Initiative (WHI) trial of combined estrogen and progestin (as Prempro) for preventing later-life ills. The trial was stopped early, in 2002, because hormone users had a higher risk of breast cancer, heart disease, stroke, and blood clots. Though the added risks were small, many women and their clinicians concluded they must discontinue hormone therapy. Many of these women found that hot flashes, sleeplessness, and other menopausal symptoms returned with a vengeance.
Hormone therapy is still considered the most effective treatment for symptoms. But women are not rushing back. One concern of health experts is that women are turning to alternatives they think are safer — but may not be.
Even before the WHI results came in, many women were looking for something different to relieve hot flashes, night sweats, and vaginal dryness. Some women disliked the side effects of hormone therapy, such as breast tenderness or bleeding. Others worried about estrogen’s link with breast cancer. Still others were opposed to taking drugs for symptoms because doing so implies that menopause is a disease rather than a normal life passage. Some women objected to the use of pregnant mares’ urine — the source of estrogen in oral conjugated equine estrogens (Premarin), the only estrogen tested in the WHI trial.