- The Washington Times - Monday, September 26, 2005

CHICAGO — Estrogen pills have little effect on older women’s quality of life, fresh evidence from a landmark study shows in yet another blow to the myth that most women need the hormones to feel better after menopause.

More than 10,000 women with an average age of 63 were asked about their general health; mental, physical and social functioning; energy level; and emotional health before and a year after they started taking either estrogen or dummy pills. All of the women in the study had undergone hysterectomies.

Some scores dipped and others increased slightly, but there was little overall difference between the groups, which each included more than 5,000 women. Women taking estrogen reported slightly fewer sleep problems but slightly worse social functioning than those on dummy pills, but the differences were minimal. Overall quality-of-life scores were high for both groups.

Participants were part of the government’s Women’s Health Initiative, which conducted a long-running study on the risks and benefits of hormones.

Use plummeted after results in 2002 linked estrogen-progestin pills sold as Prempro with an increased risk for heart attacks, breast cancer and strokes in post-menopausal women.

Later results showed that estrogen-only pills, sold as Premarin, slightly increased older women’s risk of a stroke and perhaps dementia.

The new results for estrogen-only pills echo previous data from the same study showing estrogen-progestin had little effect on older women’s overall well-being and quality of life. The study of 10,739 women appeared in yesterday’s Archives of Internal Medicine.

In both groups, fewer than 3 percent reported poor quality of life, and scores for 40 percent were in the excellent range after a year.

Several doctors said the conclusions cannot be generalized to apply to younger women.

Dr. Julia Johnson, vice chairman of gynecology at the University of Vermont, noted that the women were about 10 years past the age when troublesome symptoms such as hot flashes and night sweats, which can affect quality of life, are most likely to occur.

“Using this study to look at quality of life is sort of like comparing apples and oranges,” said Dr. Johnson, who was not involved in the study.

Dr. Ginger Constantine of Wyeth Pharmaceuticals, which makes Prempro and Premarin, said that hormone pills work for hot flashes and similar problems and that most users take the pills for those symptoms.

University of Nevada researcher Robert Brunner, the study’s lead author, said that estrogen pills reduced troublesome hot flashes in a subgroup of younger study participants but that these women still didn’t report a better quality of life than placebo users.

“Quality of life doesn’t only depend on vasomotor symptoms,” he said, noting that hormone pills have been linked with unpleasant symptoms including urine leakage that also can affect well-being.

“Yes, it’s improving some symptoms, but it’s also producing some side effects and that combination ends up resulting in no change” in quality of life, Mr. Brunner said.

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