Contact: Deborah Miller
NYU Medical Center
212/263-5800
Embargoed for release 3 p.m. (CT) Tuesday, January 25, 2000
NYU School of Medicine Women's Health Specialist Comments on
Hormone Therapy Study
Steven R.Goldstein, M.D., Professor of Obstetrics and Gynecology at New York University School of Medicine, is available to comment on a major study that reports a greater risk of breast cancer with estrogen-progesterone combination hormone replacement compared with therapy with estrogen alone.
The study will be published in the January 26 issue of The Journal of the American Medical Association, and Dr. Goldstein has reviewed and assessed the study.
Many doctors currently recommend either hormone replacement therapy with estrogen alone or a combination of estrogen and progesterone to treat symptoms of menopause and reduce the risk of osteoporosis and possibly heart disease. The hormone progesterone protects the tissue lining the uterus from the effects of estrogen, which raises the risk of uterine cancer. The combination of the two hormones is considered the standard treatment in women with an intact uterus. In women without a uterus, estrogen alone is used as a treatment.
In the new study, researchers from the National Cancer Institute evaluated whether the combination therapy increased the risk of breast cancer more than estrogen alone. Using data from 46,355 postmenopausal women who participated in the Breast Cancer Detection Demonstration Project, they found that the combination therapy was associated with a substantial increase in risk compared with estrogen alone.
"This study isn't good news for women, but there are many more options available to women than were available 20 years ago when this study began," says Dr. Goldstein, who has long experience treating menopausal and perimenopausal women, and has written extensively about treatment options for these women.
Dr. Goldstein points out that newer types of progesterone are available today, such as natural oral micronized progesterone and natural vaginal progesterone, which are safer than the progesterone likely used by women in the study. And he notes that he and other physicians are already treating women with fewer doses of progesterone, a regimen called "sporadic progesterone." These regimens employ progesterone
only two to four times a year, and rely on transvaginal ultrasound to ascertain that the lining of the uterus isn't becoming abnormally thick.
"Women who are taking hormone replacement therapy for 12 to 36 months to treat symptoms of the menopause transition shouldn't be scared away from the therapy because of this study," he says.
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