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Healthy Aging -
Most people probably think of aging as a gradual
physical decline from middle age onward, eventually
matched by a slowing down of the ability to learn or
perform intellectually. |
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The Best Way to Quit Hormone
Therapy?
Study:
Gradually Easing Off Might Not Prevent Those Hot Flashes
By Miranda Hitti
WebMD Medical News
Researchers have new information for women about how best to
quit hormone therapy after
menopause.
In terms of
hot flashes, mood problems, sexual dysfunction, and
discomfort, it may not make much difference in the long run if
postmenopausal women quit abruptly or gradually transition off
the drugs.
That finding comes from a study by Ronit Haimov-Kochman, MD, and
colleagues, at the obstetrics and gynecology department of
Hadassah Hebrew University Medical Center in Jerusalem.
The researchers found that gradually decreasing pills taken for
hormone therapy “merely postponed, and neither prevented nor
minimized, the reappearance of vasomotor symptoms (hot flashes),
mood deterioration, and sexual dysfunction, and the resulting
discomfort.”
The study appears in the
May/June issue of the journal
Menopause.
Menopause Study
The study included 91 healthy, nonsmoking, postmenopausal women
who had been on hormone therapy for more than eight years, on
average, and wanted to stop.
The women were generally in their mid-50s. They had started
hormone therapy when they hit menopause, “mostly because of
daily or nocturnal disturbing hot flushes and concern regarding
their declining quality of life,” write the researchers.
Hot flashes are also called hot flushes.
Why did the women decide to stop hormone therapy? The reasons
were “somewhat ambiguous,” the researchers write.
“Approximately 70% cited the prolonged time of treatment as the
only reason, and 25% to 46% expressed the fear of
breast cancer as being the main reason,” write
Haimov-Kochman and colleagues.
2 Approaches to Quitting
The researchers randomly asked 50 participants to stop hormone
therapy abruptly. They asked the other 41 to slowly ease off the
therapy.
“Gradual discontinuation entailed reducing the dose by one
tablet per week per month, so that complete cessation took place
after six months,” the researchers write.
The women were interviewed by telephone and by their doctors
five times after the study began (at one, three, six, nine, and
12 months).
During those interviews, the women rated how strongly -- if at
all -- they were experiencing 21 symptoms including hot flashes,
headaches, night sweats, loss of sexual interest, muscle and
joint pain, anxiety, or
depression.
Study’s Results
Slowly easing off the medication didn’t show lasting advantages
in the study.
For instance, mood disturbances were worse in the group that
stopped hormone therapy abruptly a month after quitting. But two
months later there were no differences between the groups.
In addition, few participants in either group -- only about 3%
-- reported vaginal bleeding after stopping therapy.
As for
hot flashes, those were more common in the first
three months for women who abruptly stopped taking their
medication. But six months after stopping, hot flashes were more
common among women who had gradually transitioned off the drugs.
After nine to 12 months, the groups reported no difference.
Resuming Hormone Therapy
Some women opted to resume hormone therapy, the study shows.
Twenty-one women who had abruptly stopped hormone therapy (42%
of that group) resumed after nine months. So did 15 patients
(nearly 37%) who had gradually stopped.
“The overall success of staying off HT after one year was
comparable in both groups,” the researches write.
Possible Advantage
Haimov-Kochman and colleagues mention one advantage that gradual
withdrawal from HT has over the “cold turkey” method.
They note that gradually tapering down the dose may help
pinpoint the lowest patients need to avoid symptoms such as hot
flashes. Finding that level “would enable one to treat a patient
with the smallest dose required” to control such symptoms, write
the researchers.
It’s not clear if the results apply to other groups of women.
For instance, most participants weren’t obese, so the
researchers note that they don’t know if obese women would have
a different experience.
SOURCES:
Haimov-Kochman, R. Menopause, May/June 2006; vol 13: pp
370-376. News release, The North American Menopause Society.
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© 2006, WebMD Inc. All rights reserved. |
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