In The News: Hormone Quandary

Just one year ago, doctors thought that hormone-replacement therapy could help aging women stop hot flashes while warding off heart disease, strokes, Alzheimer's and osteoporosis. Then the bad news began rolling in: women who took Prempro (combined estrogen and progestin) for five years actually increased their chances of heart attack, stroke and breast cancer. And last week the Women's Health Initiative Memory Study revealed that among 4,532 women older than 65, four years of Prempro doubled the risk of dementia. Sure, hormone therapy treats debilitating menopausal symptoms, but is it worth the risks? This much seems clear:

Women beyond menopause who are taking estrogen and progestin solely to ward off Alzheimer's or heart disease should stop. To keep hot flashes from recurring, try tapering off the drugs.

Women with mild menopausal symptoms should consider other coping strategies: wear layered clothing, avoid caffeine and spicy foods, eat more soy or try herbal remedies like black cohosh.

For women with severe night sweats and hot flashes, HRT is still the most effective treatment. But as with any drug, doctors now advise taking the smallest effective dose for the shortest time. Says Dr. Kenneth Noller, chair of obstetrics and gynecology at Tufts University, "Start with a high-enough dose to stop the hot flashes. Then after six months, see if you can start cutting back."

For more information, go to and click on "menopausal hormone therapy."