February 10, 2004
The government today told makers of hormone replacement therapies to include Alzheimer's disease and other forms of dementia on the list of possible warnings for these popular drugs. Alzheimer's will now join heart disease, strokes, and breast cancer as possible risk factors for women taking these medications.
Hormone replacement therapies containing estrogen and progestin have been used by women for decades to treat hot flashes, night sweats, and other symptoms of menopause. While the drugs may help for these troubling symptoms, a landmark study in 2002 found that they also appear to carry an increased risk of breast cancer, heart attacks, and strokes.
It was also hoped that hormone replacement therapy might keep memory intact and ward off Alzheimer's in older women. Last year, though, researchers found that it appears to do little to prevent Alzheimer's in this age group -- and may even increase the risk. [See the article, "HRT Boosts Alzheimer's Risk."] The results of that study prompted the Food and Drug Administration to require Alzheimer's disease to now be listed on the drug's warning label.
Whether to continue using estrogen and progestin combinations remains a difficult choice. Some women swear by these drugs, and the risk that a serious problem like cancer or Alzheimer's disease will actually develop because of their use appears to be very small. Women should speak with their doctors to discuss the issues and risks for them.
Experts generally caution women to use the lowest possible dose for the shortest possible time. However, as with most drugs, even low doses may carry some risks. It is unknown whether cream forms of hormone replacement therapy are safer than pills, or if different scheduled doses of progestin carry similar risks. Studies are under way.