THE TRUTH ABOUT PREMARIN The North American Menopause Society (NAMS) held its first consensus conference on the healthcare challenges of menopause, on July 15, 1997. The topic was achievement of long-term continuance of estrogen replacement therapy (ERT, defined as estrogen alone) or hormone replacement therapy (HRT, defined as estrogen plus some form of progestogen). Although ERT/HRT is not appropriate for all women as they reach menopause and beyond, HRT may be beneficial for many women. Some women, such as those experiencing surgical menopause, may benefit from estrogen/androgen therapy. If hormones are indicated for some women, optimal continuance is a clinical goal. The purpose of the conference was to determine why women who begin ERT/HRT stop taking the medication, to review what has been learned from continuance research in other therapeutic areas, to make recommendations about how to help women achieve long-term continuance of therapy, and to suggest areas for research. This consensus opinion is the outcome of that conference.
WHY DO 100,000 WOMEN
DISCONTINUE ERT/HRT EVERY MONTH?The conference focused on women who have chosen and begun prescription ERT or, for women with an intact uterus, HRT. Studies show that most women who start taking ERT/HRT discontinue therapy by the end of the first or second year. Drug report data show that every month in the United States 100,000 women discontinue ERT/HRT. *Reasons for discontinuation of ERT/HRT are the presence of side effects and lack of knowledge about ERT/HRT and its health benefits.
{Ed. Note} *That is partially true - the side effects cause many women to stop HRT. In addition, however, it is because of all the conflicting and controversial data that has emerged from the very beginning of ERT/HRT. Only 15 to 20% of menopausal women use ERT or HRT. Most women have not embraced HRT with good reason. The majority of women are extremely aprehensive of starting and continuing on a drug regimen that has a strong link to breast cancer.In Europe many studies have found a positive link between breast cancer and HRT, while in the U.S. only a few studies have shown HRT increases the risk of breast cancer. The most recent one on Janurary 26, 2000 reported by The National Cancer Institute. When a report such as the Jan. 26th one is published in the U.S., doctors mainly downplay it and say wait until the large studies come out in 2005 (the Women's Health Initiative). The U.S. medical establishment has enthusiastically recommended estrogen and HRT for many years. Doctors and researchers do not want to admit that a drug that they have been promoting heavily for many years now has a definite link to breast cancer.
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Sonja Timmers, e-mail: nrsprntg@athenet.net
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