Doctors Question Menopause Drug Therapy, Cite Research Need
A drug being given to post-menopausal women along with the hormone estrogen could be undercutting the beneficial effects of estrogen on the heart, doctors said Monday.
Dr. Elizabeth Barrett-Connor of the University of California, San Diego, said that uncertainty surrounds the use of progestin in women receiving estrogen therapy after menopause.
Progestin is a drug with the same action as the naturally occurring hormone progesterone.
Rampratap S. Kushwaha of the Southwest Foundation for Biomedical Research in San Antonio reported that progestin raised cholesterol levels in baboons whose ovaries had been removed.
Estrogen and progesterone are the two main hormones produced in the ovaries, and production of both drops almost to zero after menopause.
Estrogen is given to help reduce the hot flashes caused by the loss of the hormone production. Since the 1970s, when it was shown that giving a woman estrogen could increase her risk of uterine cancer, progesterone has been used to reduce that cancer risk, Barrett-Connor said.
But estrogen also protects women against heart disease. Without estrogen, their risk of heart disease climbs sharply after menopause, becoming similar to that of men after a few years.
Barrett-Connor was one of several researchers who called for more research on heart disease in women.
At a news conference during the annual scientific meeting of the American Heart Assn., the researchers said that many questions, such as how to use estrogen and progesterone in post-menopausal women, can’t be answered without new studies.
Barrett-Connor said, for example, that older women have higher blood pressure and cholesterol on average than do men, but they still have lower risks of heart disease. Researchers do not know why.
John LaRosa of George Washington University Medical Center said the fat that women often carry on their hips may raise their heart disease risk less than fat carried around the abdomen, as is more common in men.
Charles Hennekens of Harvard Medical School cautioned, however, that “obesity in women is a major public health problem.”
A woman who is 10% above average weight has an 80% higher risk of heart disease, he said. A woman who is 20% above average weight has a 230% higher risk of heart disease.
