And the hormone debate continues’

Two new studies are adding fuel to the debate about the safety and benefits of HRT (hormone replacement therapy), used to ease the symptoms of menopause.

First the bad news: A study in the U.S. Journal of the National Cancer Institute found that women who had previously had breast cancer were 14 percent more likely to have it return if they used HRT. In a press release, the researchers classified this increased risk as “substantive.”

Now for the good: A British study suggests that the extra estrogen supplied by HRT helped prevent the build-up of proteins in the brain that are thought to be responsible for Alzheimer’s. Previous research concluded that HRT offers no protective effects on the brain, but experts at the Institute of Psychiatry at King’s College London, who conducted this latest study, say age appears to play a role and that the earlier research focused on older women who did not receive hormones immediately after menopause.

"There may be a critical window of time around the menopause when HRT may have a beneficial effect in protecting against Alzheimer’s dementia,” said lead author Dr. Michael Craig.

So what to do? We can only suggest that you talk to your doctor. A couple years back I interviewed Dr. Robert Reid, professor of obstetrics and gynecology and chair of the division of reproductive endocrinology and infertility at Queen’s University, and he said the severity of symptoms should be your guide. If symptoms such as hot flashes, vaginal dryness and sleep disturbances are getting in the way of normal life, then it’s worth exploring your options. But he also recommended lifestyle changes such as exercise and limiting alcohol as the first course of action.

The debate over HRT exploded six years ago, when the first reported results of the Nurse’s Health Study found hormones boosted the risk of breast and ovarian cancers, strokes and other conditions.

What about you? Have the back-and-forth reports on the effects of hormones impacted your decision whether or not to use them? Are you more likely to try a natural remedy, such as black cohosh (which, by the way, has been shown to be ineffective)? How do you manage hot flashes? Email us to get in on the debate. (Reuters, BBC)