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Possible benefits of Hormone Replacement Therapy

According to a study, estrogen replacement therapy does not reduce post-menopausal women's risk of having a second stroke. The Women's Estrogen for Stroke Trial (WEST) is the recent study to counter long-held notions// about the benefits of hormone replacement therapy, or HRT, on the heart and blood vessels. Catherine Viscoli, a research scientist University of Yale, said that a lot of people thought estrogen was a magic pill.

So-called observational studies, in which women decided on their own whether to go on HRT after menopause, have suggested that the treatment cuts risk of heart attacks and stroke. But some scientists speculated that women who opt for HRT might tend to be healthier, tilting those studies in the treatment's favor. That has led to randomized controlled trials such as WEST, which are considered the gold standard of medical research. Recent randomized trials, in which a coin toss determines who goes on HRT, have found no benefit and perhaps even harm from the treatment.

Joann Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital, said that there has been a sea change in our understanding of hormone replacement therapy and cardiovascular disease. Manson and other experts now recommend that women go on HRT only for relief of menopausal symptoms or prevention of osteoporosis fractures, although other treatments are available for the latter.

WEST researchers, funded by the National Institute of Neurological Disorders and Stroke, studied 600 postmenopausal women who had recently had an ischemic stroke or transient ischemic attack. Their average age was 75. Ischemic strokes, the more common type of stroke, occur when a clot blocks blood flow to part of the brain. Transient ischemic attacks, or TIAs, occur when the blood flow is only briefly interrupted. Most TIA symptoms disappear within an hour, but they are warning signs that a person is at risk for a more serious stroke.

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