Michelle Greiver, M.D., C.C.F.P.
Family Physician
240 Duncan Mill road, suite 705
Toronto, Ontario M3B 3S6
Phone (416) 222-3011
Fax (416) 221-3097
Email  mgreiver@rogers.com

May 16, 2004

The Women’s Health Initiative Study:

Hormone replacement after Menopause

Patient Handout

What is the Study?

This is a study involving over 16,000 women, ages 50 to 79.  All the women were post-menopausal; half were given estrogen and progesterone hormone pills, and the other half received placebos (sugar pills).  The researchers stopped the study shortly after 5 years, because women taking the hormones were found to have more of certain health problems.

What were the results?

For every 10,000 women, per year, the hormone pills caused:

7 more heart attacks
8 more strokes
8 more blood clots in the lung
8 more breast cancers
6 less colon cancers
5 less hip fractures

What does this mean to me?

It depends.  If you are taking hormones because you are having a lot of difficulties during menopause (such as hot flushes), this study does not mean you have to stop.  The risk for any one woman is very low over the short term, so if your quality of life is much better on the hormone pills, it is reasonable to continue them for a while.

However, if you are taking hormone pills long term to prevent health problems, you should reassess this together with me.  The researchers concluded that hormone pills should not be used to protect against heart disease, and the study showed us that, overall, the hormones caused more problems that they prevent.

What if I’m only on Estrogen?

Women who have had a hysterectomy take estrogen only, not the combined estrogen/progesterone pills.  The results of the study on estrogen only are now available, and have shown that, for every 10,000 women, per year, the estrogen caused:

12 more strokes
7 more blood clots
6 fewer hip fractures
There were no extra breast cancers.  Because of the extra risk of stroke, the researchers concluded that estrogen alone should not be used to prevent health problems.

How can I stay healthy after Menopause?

There is lots of research showing that eating a healthy, balanced diet and regular exercise helps to keep women healthy; that is the basis of good prevention.Controlling your blood pressure and cholesterol will prevent heart disease, and not smoking will definitely make a difference.There are medications that have proven their worth for heart disease prevention, if needed, such as ASA and cholesterol lowering drugs. We also have effective medication for osteoporosis prevention, and it is a good idea to get enough calcium:  3 to 4 servings of milk or milk products per day, or calcium supplements if you can’t drink enough milk.

What is encouraging about this study is that it showed us that menopause not as great a threat to women’s health as we once thought.  In fact, the majority of women in the study stayed healthy: a good diet and regular exercise remain at the center of every woman’s wellness program.

If you have any other questions, please ask me.