Menopause: New advice on hormone treatment

About one in five women going through menopause have symptoms severe enough to make their lives miserable from time to time. No woman, after all, wants to start sweating profusely in public after a hot flash. And night sweats and difficulty sleeping can leave a woman tired, groggy, irritable, and less than productive for days on end.

But the main drugs used to treat such problems —the hormones estrogen and progestin—have long had a bad rap. They have been linked since 2002 to a broad array of serious risks, including breast cancer, heart attack, and stroke. In our research, we found that new studies of hormone use often get wide media attention, and add to an already confusing topic for women. Our Consumer Reports Best Buy Drugs project has taken a careful look at the evidence on hormone products in a new report that cuts through the confusion and gives women straightforward advice.

The good news is that hormone drugs are now deemed to be a viable option for younger, healthy women who have severe symptoms and desperately need relief. In particular, women under the age of 60 who are at a low risk for heart problems may not increase their risk of heart disease when they take hormones. However—and it's a big however—they still face an increased risk of breast cancer, blood clots, and stroke. So, hormones still need to be prescribed and taken with extreme care, even for women who have severe symptoms.

The report advises women with mild symptoms to avoid hormones and seek relief through lifestyle and habit changes, such as quitting smoking, exercising regularly, sleeping in a cool room, and dressing in loose-fitting clothes. Women who have heart disease or are at high risk of it, as well as women who may be at high risk of breast cancer, are also advised to steer clear of the drugs.

The new report also examines the cost of hormone drugs. Most are reasonably priced.  Even so, we recommend asking your doctor to prescribe a generic.  Most generic estradiol pills, for example, cost less than $15 a month, and could save you up to $400 over brand-name Premarin. The full report lists 14 Best Buy hormone products, including pills, patches, and vaginal creams and rings.

Read the full report to learn more.

—Steve Mitchell, associate editor, Best Buy Drugs

Comments

[x-ray fluorescence]

Hi,
Good information.Hormone treatments commonly used by menopausal women appear to accelerate brain shrinkage.

[Virginia L. DeLaney]

I recently had to have a biopsy on my right breast because a very small mass was found and I had a cyst under my nipple. It was a nightmare experience for nothing! I was forced to have the procedure because I was taking hormones. Because the mass was the size of a pencil eraser...I had to have a ultrasound so the doctor could find the cyst and mass. He was inexperienced. MY MISTAKE....I should have asked for his track record. He raped my breast with his instruments and did not preform a biopsy....he removed the whole mass with 12 parts. I did not have cancer and my entire breast turned black and I had an infection and hematoma. No one explained the procedure to me. I went from my GYN to a SURGEON to the hospital where an unknown doctor, the radiologist preformed the procedure...something new and I was his learning tool. Last year the SURGEON performed a biopsy in his office...NO CANCER. I am sick of the probing. I never felt I had cancer and I never wanted the biopsies....but to continue on the hormone my doctor said I had to do the procedure...ethics......I will never have another biopsy. I will never have another mammogram. I will be off the pills in one year. I am 59 years old and angry. I now live with scar tissue in my breast and a big lump and pain. Don't tell me that I am lucky because I did not have cancer. I am a cancer survivor. Thyroid cancer. However. never never again will I take treatment. I will not let the medical profession use me for their fininacial gain. When I die....I just want to die. Let it be cancer or whatever takes me. This year I lost my faith in the medical professionals. The radiologist at SouthEastMed Cambridge, Ohio "raped" my breast. I laid awake and heard how excited he was to finally reach the mass and take all of it. That is not a biospy! I laid awake and heard him....as he treated me like a "nothing" and a "no one." NO MORE. Give me breast cancer, I can die with that. But I cannot live with modern medicine's probing.