Q. I am totally confused about hormone therapy. I used to take Premarin to keep my bones stronger and reduce the risk of a heart attack. Then a friend who is a nurse pleaded with me to stop taking hormones because they can cause breast cancer.
Now I am suffering joint pain as well as hot flashes. I would like to go back on Premarin, especially since I just heard it is good for the heart after all. Do you have any information that will help me?
A. There is no more controversial topic than hormone replacement therapy (HRT). For decades women were told that estrogen and progestin could keep bones strong and hearts healthy. Then a large study (Women’s Health Initiative) cast doubt on the benefits of HRT. Women were told that these hormones could increase the risk of breast cancer and heart disease.
A new analysis of this research reveals that women in their 50s who had hysterectomies and were only taking estrogen had less calcified plaque in their heart arteries. Although this is somewhat reassuring, HRT still poses a risk of breast cancer.
We are sending you our Guide to Estrogen: Benefits, Risks and Interactions for more details on this controversy and some non-drug ways to cope with hot flashes. Age seems to be a critical factor in HRT safety. Older women, beyond 60, may be at increased risk for heart attacks and strokes.