http://www.washingtonpost.com/wp-dyn/content/article/20...AR2007092101394.html

Most Women Unaware of Hormone Replacement Study

By Kathleen Doheny
HealthDay Reporter
Friday, September 21, 2007; 12:00 AM

FRIDAY, Sept. 21 (HealthDay News) -- Most women are unaware of the results of a large-scale study, released in 2002, that found significant cancer and heart risks associated with long-term hormone replacement therapy (HRT).

That study, called the Women's Health Initiative, generated massive amounts of publicity immediately after it was released. Its data caused many American women to abandon HRT altogether.

But just two years later, in June 2004, fewer than a third of women surveyed by Stanford University researchers said they knew about the findings.

"I was quite surprised by that. Other research had indicated that up to half had heard about it," said senior researcher Dr. Randall Stafford, associate professor of medicine, Stanford Prevention Research Center, Stanford University, Stanford, Calif., and the senior author of the study.

His team's study is published in the September/October issue of the journal Menopause.

When Stafford and his colleagues interviewed 781 women between the ages of 40 and 60, only 29 percent knew about the study. The question was posed this way: "Have you heard or read anything about the results of the Women's Health Initiative (WHI), a major research study in the U.S. suggesting the health risks of taking hormone therapy outweigh the benefits for most women?"

Those polled included 252 women who had not yet entered menopause, 88 classified as perimenopausal (having irregular menstrual cycles, but at least one period in the past 12 months), 227 women who were in or past menopause, and 196 who had surgically induced menopause after having undergone hysterectomy. For 18 women, menopausal status wasn't known due to missing data.

Next, the researchers ask whether HRT increases, decreases or has no impact on the risk of seven health conditions, including memory loss, heart disease, blood clots, stroke, osteoporosis, breast cancer and colorectal cancer.

Only 40 percent of the women answered more of these questions correctly than incorrectly. While 64 percent knew that hormones were thought to increase breast cancer risk, for example, only 9 percent knew the supplemental hormone regimen increased memory loss risk. Just 34 percent understood that HRT might boost their cardiovascular risk.

When asked if they had talked about hormone therapy with their doctors, the researchers found that 36 percent of women aware of the WHI findings had talked about it with their physicians. But only 15 percent of those who didn't know about the study results did.

"We need to do a better job of disseminating information," Stafford said, referring to the health care system.

But another expert familiar with the study viewed the results a bit differently. Some of the women may not have been even thinking yet about menopause, since the survey included women as young as 40, for whom menopause is typically 5 to 10 years away, noted Dr. William Parker, staff gynecologist and past chair of obstetrics and gynecology at Santa Monica-UCLA Medical Center and the Orthopaedic Hospital, Santa Monica, Calif.

"The unanswered question is, 'How many women who need to know the information now do not have it?' " said Parker, who is also clinical professor of ob-gyn, University of California, Los Angeles, School of Medicine.

If a woman is not at the point where she has to make a decision about hormone therapy, he said, it would not jeopardize her care if she was unaware of the study and its findings and didn't have a conversation with her physician.

In his own practice, Parker said, "If a woman is, say, age 48, and comes in, says she is having occasional hot flashes but is still having periods, I tell her, 'Let's have a conversation when you need it, because this information changes so quickly.' " Since the original WHI results were released in 2002, numerous re-analyses have been done of the study to confirm or negate the original findings, he noted.

Unless a woman needs the information immediately, Parker reasoned, the office visit time would probably be better spent on other concerns or preventive health.

The study was funded by the National Heart, Lung, and Blood Institute and GlaxoSmithKline Consumer Healthcare. The pharmaceutical company was interested in the data due to its black cohosh product for menopausal symptom relief, Stafford said.

More information

To learn more about the Women's Health Initiative, visit the National Heart, Lung, and Blood Institute.

SOURCES: Randall Stafford, M.D., Ph.D., associate professor, medicine, Stanford Prevention Research Center, Stanford University, Stanford, Calif.; William Parker, M.D., staff gynecologist and past chair of obstetrics and gynecology, Santa Monica-UCLA Medical Center and Orthopaedic Hospital, Santa Monica, Calif., and clinical professor, ob-gyn, University of California, Los Angeles, School of Medicine; September/October 2007,Menopause

Another report on this study from the New York Times:

http://www.nytimes.com/2007/10/02/health/research/02per...f=health&oref=slogin

By ERIC NAGOURNEY
Published: October 2, 2007

When a major study reported that the hormone replacement therapy routinely given to postmenopausal women for years appeared to do more harm than good, a few effects were immediate. Prescriptions and public discussions dropped sharply.

Two years later, a survey finds 3 in 10 women recalled anything about the study, and fewer than half were familiar with the pros and cons of the therapy.

Writing in the journal Menopause, researchers said the findings suggested that more education was needed so that menopausal women could make informed decisions. The lead author of the study was Alison J. Rigby of Stanford.

Researchers surveyed almost 800 women, ages 40 to 60, about a 2002 study from the Women’s Health Initiative. The hormones appeared to increase the risk of breast cancer, heart attack, stroke and other illnesses. Now the hormones are mainly recommended during menopause to reduce symptoms.

While doctors are presumably much more likely to be aware of the risks of the therapy, the senior author of the study, Dr. Randall S. Stafford of Stanford, said that was not enough. It was unclear how much some doctors knew about hormone replacement, Dr. Stafford said, and, just as important, how well they educated their patients.

“By and large,” he said, “patients are very frustrated and disappointed by the sort of communication that they have with their physicians.”