Women and their doctors have a major problem when menopause rolls around.
Menopause is not a pleasant time for most women. It is full of changes. Not only do periods become more scarce and irregular, making birth control difficult, but many have “Hot Flashes”, “Night Sweats” and a host of symptoms that would cause the average male to commit suicide. The change that is most distressing is that the sex drive diminishes and the body loses some of its appeal.
It is at this point that a woman will approach her doctor and say: “Can’t I have replacement estrogen? I’ve heard all about it from my girl friends.”
About two decades ago almost all doctors would have smiled and written a prescription for an “estrogen pill” either daily or rarely, monthly. Premarin is the American favorite and it was prescribed like candy for menopausal women.
The code name for this treatment was, HRT or Hormone Replacement Therapy. HRT was popular, not only in the U.S., but across the world.
The one thing all doctors learn, is that: “What’s true today will be false 20 years from now.” This applied to HRT. The world medical community discovered that estrogen replacement was killing women.
HRT caused more breast cancer, more strokes, and more heart attacks. Yet, it did increase sexual desire and prevented aging. Like everything in life, it was a trade-off between some good and some very bad.
Doctors and pharmaceutical companies took the high road. Low dose estrogen was formulated and then given locally, as a cream or suppository. Many women were unhappy with this approach. They wanted the strong stuff. These women began to badger their doctors for the old stuff.
Some male doctors, especially the older ones, caved in. Most took the hard road and resisted the importuning (begging). Yet, today, 20 years after the change was made, there are still millions of women in the U.S. taking the killer pills.
Here is the report from Reuters:
US Women Still Taking High-Dose Hormone Pills: Study
By Maggie Fox, from Reuters Health Information
WASHINGTON (Reuters) Dec 03 -” Prescriptions for hormone replacement therapy (HRT) have fallen more than 50% in the United States since 2001, but doctors are still inexplicably giving women high-dose pills linked to strokes and cancer, researchers report.
“We’re disappointed,” Dr. Randall Stafford of Stanford University in California, who led the study, said in a statement Thursday. “Yes, there was an increase in the use of low-dose preparations, but it was not sizeable.”
Dr. Stafford and colleagues looked at data from 340,820 patient visits to hospitals, clinics and doctor’s offices, as well as information from telephone calls.
They found that use of HRT fell by 52% from 2001 to 2009, from 17.5 million users to 8.3 million users. But the women using HRT were often still getting relatively high doses of hormones.
“Despite reduced use, standard-dose oral (HRT) remains the dominant formulation, yet lower dose transdermal and vaginal preparations may yield less harm,” they wrote in their paper, which appeared online November 24th in Menopause.
“We thought that over time there might be greater tailoring of therapy based on characteristics of the individual woman,” Dr. Stafford said. “The bottom line is that over time we didn’t see the level of refinement in clinical practice that we expected.”
Many experts believe that lower-dose formulations and skin patches may be a safer way to deliver HRT. The patches, in particular, may reduce the amount of hormones reaching vulnerable organs.
In 2001, more than 16 million women took some form of HRT pill, but by 2009, 6 million did, the survey found.
Lower-dose product use increased modestly, from 700,000 in 2001 to 1.3 million in 2009, they found.
In October, 11-year follow-up data from the Women’s Health Initiative showed that women who took hormone replacement pills had more advanced breast cancers and were more likely to die from them than women who took a placebo. (See Reuters Health story of Oct 20, 2010.)
HORMONE REPLACEMENT THERAPY
In June, a different team found that women using low-dose patches were less likely to have strokes than women taking pills.” (See Reuters Health story of Jun 4, 2010 for more information.)
Dr. Pinna says:
Six million women taking pills that may kill them, prescribed by doctors who do not care. Somehow, I feel that these doctors should be given a “Restricted License” that allows them only to treat men.