MinTankesmie

- Hormonbruk kan ha gitt mange kvinner brystkreft

Hormonbruk kan ha gitt mange kvinner brystkreft
nrk.no 9.3.2012
Hormonbehandling førte til en rekke tilfeller av brystkreft hos norske kvinner mens bruken var på det høyeste. Etter meldinger om kreftrisiko falt hormonbruken, og nå er omfanget som på begynnelsen av 1990-tallet.

Ny norsk studie bekrefter tidligere resultater om at mange norske kvinner hvert år unødvendig fikk brystkreft på grunn av hormonbehandling mot plager i overgangsalderen.

Bruken av hormoner eksploderte i Norge på slutten av 1990-tallet. Av mange ble pillene sett på som en vidunderkur mot aldring.

Fra 1990 til 1999 ble omfanget av hormonbehandling i Norge nesten femdoblet.

• Les: Mammografi skaper overbehandling

Legemidlene inneholder østrogen, som regel i kombinasjon med et annet hormon, progesteron. Det ble imidlertid ropt varsku da internasjonal forskning viste at preparatene ga økt risiko for brystkreft.

Fra 2003 kom det nye retningslinjer i Norge som strammet inn bruken. Omfanget av hormonbehandling er nå betydelig redusert. (...)

- Artikler som bestrider link mellom HRT og brystkreft er "latterlige"

Articles disputing link between HRT and breast cancer are “ridiculous” (Artikler som bestrider link mellom HRT og brystkreft er "latterlige")
BMJ 2012;344:e513 (19 January)
A leading epidemiologist has condemned a group of authors for writing and a journal for publishing a series of articles challenging the well established link between hormone replacement therapy (HRT) and breast cancer, describing their actions as “a disgrace.”

Klim McPherson, visiting professor of Public Health Epidemiology at the Nuffield Department of Obstetrics and Gynaecology at the University of Oxford, described the arguments used by the authors as “tortuous and ridiculous.”

He told the BMJ, “If the scientific consensus can incorporate uncertainty about this relationship then people can market and prescribe HRT and downplay its importance.”

Samuel Shapiro, visiting professor of epidemiology at the University of Cape Town, and colleagues looked at the design of three major pieces of research that prompted a rethink of the long term safety of HRT—the Collaborative Reanalysis (Lancet 1997;98:498-509), the Women’s Health Initiative (JAMA 2002;288:321-3; JAMA 2006;295:1647-57), and the Million Women Study (Lancet 2003;362:419-27). Their articles are published in the Journal of Family Planning and Reproductive Health Care (doi:10.1136/jfprhc.2011.0078; doi:10.1136/jfprhc-2011-0090; doi:10.1136/jfprhc-2011-0091;doi:10.1136/jfprhc-2011-100229). (...)

- Diverse artikler

Flere dør av livmorkreft - overvekt kan være årsaken
tv2nyhetene.no 17.4.2012
Stadig flere kvinner får livmorkreft, og antall dødsfall har økt med 34 prosent fra 1999 til 2009. Forskere mener overvekt kan forklare økningen i forekomsten. (...)

700 kvinner får diagnosen årlig
Rundt 700 norske kvinner får diagnosen og 146 kvinner dør av livmorkreft årlig.

I 1999 døde 113 av livmorkreft, og i 2009 151 kvinner. Det er en økning på 34 prosent i antall dødsfall.

I samme periode fra 1999 til 2009 økte forekomsten av livmorkreft med 20 prosent. (...)

Pfizer Says Nearly Half of Prempro Lawsuits Are Settled
pharmpro.com 16.12.2011
According to a Securities and Exchange Commission filing, Pfizer has settled almost 5,000 lawsuits, or 46 percent of cases, related to allegations that patients developed breast cancer after taking the company's hormone replacement therapies Prempro, Premarin and Provera, Bloomberg reported Thursday.

The drugmaker also indicated that it has set aside a further $68 million in addition to the $772 million it set aside for the cases in May, at which time Pfizer said it had resolved a third of the lawsuits, or about 3300. "We have recorded a charge of $260 million in the first nine months of 2011 that provides for the minimum expected costs to resolve all the remaining hormone-replacement actions," Pfizer officials said in the filing. However, the company noted that the reserve for the remaining lawsuits is only "an estimate" and "additional charges may be required." (...)

Estrogen-Only Therapy May Be Less Risky Than Doctors Thought
healthland.time.com 5.4.2011
Strokes and other health problems linked with estrogen pills appear to fade when women quit taking them after menopause, the first long-term follow-up of a landmark study found. It's reassuring news for women who take the hormone in their 50s when menopause usually begins.

The latest study bolsters previous evidence that concerns about breast cancer and heart attacks are largely unfounded for those who take the hormone for a short period of time to relieve hot flashes and other menopause symptoms. (...)

Delaying Hormone Use Cuts Breast Cancer Risk
medpagetoday.com 28.1.2011
Women who begin using hormone therapy close to the time of menopause are at greater risk for breast cancer than those who wait five years or more, a large prospective study found. (...)

Estrogen Plus Progestin and Breast Cancer Incidence and Mortality in Postmenopausal Women (Østrogen pluss progestin og kreftforekomst og dødelighet hos postmenopausale kvinner)
JAMA. 2010;304(15):1684-1692 (October 20)
Context In the Women's Health Initiative randomized, placebo-controlled trial of estrogen plus progestin, after a mean intervention time of 5.6 (SD, 1.3) years (range, 3.7-8.6 years) and a mean follow-up of 7.9 (SD, 1.4) years, breast cancer incidence was increased among women who received combined hormone therapy. Breast cancer mortality among participants in the trial has not been previously reported. (...)

Conclusions Estrogen plus progestin was associated with greater breast cancer incidence, and the cancers are more commonly node-positive. Breast cancer mortality also appears to be increased with combined use of estrogen plus progestin. (...)

Hormone Therapy Ups Mortality in Breast CA (Hormonterapi øker dødeligheten for brystkreft)
medpagetoday.com 19.10.2010
In absolute terms, there were 25 breast cancer deaths in the HT group and 12 in the placebo group, which equaled rates of 0.03% and 0.01% per year, Chlebowski and co-authors wrote in the Oct. 20 issue of the Journal of the American Medical Association. (...)

Court won't stop hormone replacement lawsuits (Retten stanser ikke hormonterapi-søksmål)
pharmpro.com 12.10.2010
The Supreme Court won't reconsider a decision to reinstate more than 100 lawsuits filed by women who claimed that hormone replacement therapy caused breast cancer.

The high court refused on Tuesday to hear an appeal from Wyeth LLC and other pharmaceutical companies. (...)

Kidney Stones Tied to Estrogen Therapy (Nyresteiner knyttet til østrogenterapi)
medpagetoday.com 11.10.2010
Estrogen therapy in post-menopausal women appears to increase the risk of kidney stones, researchers reported.

Data from two large placebo-controlled trials -- part of the Women's Health Initiative program -- showed that the annual rate of kidney stones in women getting estrogen was 39 per 10,000 women, according to Naim Maalouf, MD, of the University of Texas Southwestern Medical Center in Dallas, and colleagues.

On the other hand, among women getting placebo in the two trials, the rate was 34 per 10,000 women per year, Maalouf and colleagues reported in the Oct. 11 issue of the Archives of Internal Medicine. (...)

(Anm: Postmenopausal Hormone Use and the Risk of Nephrolithiasis. Arch Intern Med. 2010;170(18):1678-1685 (October 11).)

Drug co. paid writers to promote hormone therapy (Legemiddelfirma betalte forfattere for å promotere hormonterapi (HRT))
reuters.com 8.9.2010
(Reuters) - Drugmaker Wyeth used ghostwriters to play up the benefits and downplay the harm of hormone replacement therapy in articles published in medical journals, a U.S. researcher said on Tuesday.

Dr. Adriane Fugh-Berman of Georgetown University Medical Center in Washington analyzed dozens of ghostwritten reviews and commentaries published in medical journals and journal supplements, many of them using documents from judicial trials.

Hun sa at Wyeth, nå eiet av Pfizer, betalte et medisinske kommunikasjonsfirmapaid kalt DesignWrite 25 000 doaalr for å spøkelsesskrive artikler på kliniske studier, inklusive fire som testet lavdose for Prempro, firmaets kombinerte østrogen/progestin-terapi. (She said Wyeth, now owned by Pfizer, paid a medical communication company called DesignWrite $25,000 to ghostwrite articles on clinical studies, including four testing low-dose Prempro, the company's combination estrogen-progestin therapy.)

She said the articles were intended to mitigate concerns that hormone replacement therapy raises the risk of breast cancer, and to support the unfounded idea that the drugs offer some protection against heart disease. (...)

Ghostwritten articles overstated benefits of HRT (Spøkelsesskrevne artikler overdrev nytten av HRT (hormonterapi))
BMJ 2010; 341 (7 September)
Gjennomgangsartikler og kommentarer som var spøkelsesskrevne overdrev nytten av hormonterapi og tonet ned dets skadevirkninger, ifølge en analyse publisert I PLoS Medicine (2010;7(9):e1000335, doi:10.1371/journal.pmed.1000335). (Review articles and commentaries that were ghostwritten overstated the benefits of hormone replacement therapy and downplayed its harms, says an analysis published in PLoS Medicine (2010;7(9):e1000335, doi:10.1371/journal.pmed.1000335).)

Resultatene stammer fra en undersøkelse av 1 500 dokumenter fremlagt i en nylig rettssak mot det store legemiddelfirmaet Wyeth (nå en del av Pfizer) som undersøkte hvordan legemiddelfirmaer bruker spøkelsesforfattere til å plassere markedsføringsbudskap i artikler som publiseres i medisinske tidsskrifter. (The finding is from an analysis of 1500 documents unsealed in recent litigation against the giant drug company Wyeth (now part of Pfizer) that looked at how drug companies use ghostwriters to insert marketing messages into articles published in medical journals.)

Adriane Fugh-Berman, associate professor in the department of physiology at Georgetown University Medical Center in Washington, DC, who led the analysis, calls on the medical profession to take action to prevent the “unscrupulous relationships” between the industry and academia.

“Given the growing evidence that ghostwriting has been used to promote HT [hormone therapy] and other highly promoted drugs, the medical profession must take steps to ensure that prescribers renounce participation in ghostwriting, and to ensure that unscrupulous relationships between industry and academia are avoided rather than courted,” she wrote in the article. (...)

(Anm: Hormonterapi (HRT-behandling) (Hormon Replacement Therapy) (mintankesmie.no).)

(Anm: The Haunting of Medical Journals: How Ghostwriting Sold “HRT”. PLoS Med 7(9): e1000335 (September 7).)

Hormone replacement may not save women's muscle
reuters.com 20.8.2010
(Reuters Health) - Despite some earlier evidence that hormone replacement therapy after menopause can help maintain women's muscle mass, a new study suggests that any such benefit does not last. (...)

Hormone Therapy Increases Chance of Breast Cancer
Ivanhoe.com 11.8.2010
(Ivanhoe Newswire) – Hormone treatments are commonly used for postmenopausal women, but a new study shows even more evidence this therapy increases the risk of breast cancer. (...)

Nytt hormonmiddel overbeviser ikke
Tidsskr Nor Legeforen 2010; 130:1116 (3.6.2010)
(...) – De viktigste gevinstene er den bruddforebyggende effekten. Baksiden av medaljen er at risikoen for venøs trombose og for lungeemboli økte med 1 %, mens risikoen for dødelig slag gikk opp med 0,2 %, sier lege og seniorforsker Gro Berntsen ved Nasjonalt senter for telemedisin og samhandling. (...)

Hormonterapi gir økt kreftrisiko
vg.no 8.5.2010
Mange års bruk av kombinasjonspreparater ved plager i overgangsalderen dobler risikoen for livmorkreft. Professoren som har gjennomført undersøkelsen sier resultatet er overraskende.

- Det vi trodde var trygt, er likevel forbundet med økt risiko, sier professor Giske Ursin til Dagens Medisin.

Fra før av har flere studier vist økt risiko for brystkreft ved bruk av hormonterapi for plager i overgangsalderen. Det har også vært kjent at østrogentilskudd alene kan øke risikoen for livmorkreft. (...)

Hjärtrisk kvarstod i flera år efter inledd hormonterapi
dagensmedicin.se 17.2.2010
Behandling med östrogen och progesteron efter klimakteriet kan medföra en något ökad risk för kranskärlssjukdom under de sex första åren av behandling. Detta enligt forskare bakom en ny analys. (...)

(Anm: Coronary Heart Disease in Postmenopausal Recipients of Estrogen Plus Progestin Therapy: Does the Increased Risk Ever Disappear?
A Randomized Trial. Ann Intern Med 2010;152(4):211-217 (February 16).)

Hormonersättning kopplas till astma
lakemedelsvarlden.se 10.2.2010
Behandling med hormonersättning hos kvinnor i klimakteriet kan öka risken för astma. Störst är risken för de som behandlats med östrogen, det visar en fransk studie som studerat 58 000 franska kvinnor. (...)

Menopause, as Brought to You by Big Pharma
nytimes.com 12.12.2009
MILLIONS of American women in the 1990s were told they could help their bodies ward off major illness by taking menopausal hormone drugs. Some medical associations said so. Many gynecologists and physicians said so. Respected medical journals said so, too. (...)

Connie Barton, then a medical office assistant in Peoria, Ill., was one woman who responded to such messages. She says she took Prempro, a hormone drug made by Wyeth, from 1997, when she was 53, until 2002, when she received a diagnosis of breast cancer. As part of her cancer treatment, she had a mastectomy to remove her left breast.

Now Ms. Barton, who said in an interview that she used Prempro in part because her doctor told her it could help prevent heart disease and dementia, is one of more than 13,000 people who have sued Wyeth over the last seven years, claiming in courts across the country that its menopause drugs caused breast cancer and other problems.

The suits also assert, based on recently unsealed court documents, that Wyeth oversold the benefits of menopausal hormones and failed to properly warn of the risks. (...)

Wyeth använde falska artiklar
lakemedelsvarlden.se 11.8.2009
I samband en rättslig process har tidigare hemliga dokument offentliggjorts som tyder på att företaget Wyeth låtit publicerat falska artiklar om sina storsäljande hormonpreparat Prempro och Premarin. Historien som nu rullar upp visar på manipulerade data och tvivelaktig marknadsföring.

FALSKSPEL Av dokumenten som blev offentliga i början av augusti framgår att det amerikanska läkemedelsföretaget Wyeth använt spökskrivare till ett 30-tal artiklar.

Artiklarna, som stöder användningen av hormonersättningsmedel hos kvinnor, har publicerats i flera tunga vetenskapliga tidsskrifter som The American Journal of Obstetrics and Gynecology och The International Journal of Cardiology. I artiklarna framhävs de positiva effekterna av hormonterapier, HRT, samtidigt som biverkningarna tonats ner. (...)

Medical Papers by Ghostwriters Pushed Therapy (Medisinske artikler og studier forfattet av spøkelsesforfattere pushet terapi)
nytimes.com 4.8.2009
Newly unveiled court documents show that ghostwriters paid by a pharmaceutical company played a major role in producing 26 scientific papers backing the use of hormone replacement therapy in women, suggesting that the level of hidden industry influence on medical literature is broader than previously known.

The articles, published in medical journals between 1998 and 2005, emphasized the benefits and de-emphasized the risks of taking hormones to protect against maladies like aging skin, heart disease and dementia. That supposed medical consensus benefited Wyeth, the pharmaceutical company that paid a medical communications firm to draft the papers, as sales of its hormone drugs, called Premarin and Prempro, soared to nearly $2 billion in 2001.

But the seeming consensus fell apart in 2002 when a huge federal study on hormone therapy was stopped after researchers found that menopausal women who took certain hormones had an increased risk of invasive breast cancer, heart disease and stroke. A later study found that hormones increased the risk of dementia in older patients. (...)

The documents on ghostwriting were uncovered by lawyers suing Wyeth and were made public after a request in court from PLoS Medicine, a medical journal from the Public Library of Science, and The New York Times. (...)

Because physicians rely on medical literature, the concern about ghostwriting is that doctors might change their prescribing habits after reading certain articles, unaware they were commissioned by a drug company. (...)

Hormone replacement therapy tied to ovarian cancer (Hormonterapi knyttet til eggstokkreft)
reutershealth.com 14.7.2009 (Reuters Health)
NEW YORK (Reuters Health) - New research suggests that no matter how hormone replacement therapy is given, it increases the risk of ovarian cancer.
Hormone replacement therapy, consisting of estrogen, progesterone, or both, and used to relieve the symptoms of menopause, has been linked to breast cancer, Dr. Lina Steinrud Morch, from Rigshospitalet, Copenhagen, Denmark, and colleagues note in their study. Some studies have suggested that it could raise the risk of ovarian cancer. (...)

(Anm: Hormone Therapy and Ovarian Cancer. JAMA. 2009;302(3):298-305. (July 16).)

Study questions benefits of immediate hormone therapy after menopause (Studie stiller spørsmål ved umiddelbar hormonterapi etter overgangsalder)
BMJ 2009;338:b2236 (4 June)
No evidence shows that hormone therapy started soon after menopause has a beneficial effect, according to a study in the American Journal of Epidemiology (2009 May 25, doi:10.1093/aje/kwp115). The authors found no support for the postmenopausal oestrogen timing hypothesis—that is, that treatment initiated soon after menopause prevents coronary heart disease and that treatment started later has a null or adverse effect. (...)

(Anm: Benefits and Risks of Postmenopausal Hormone Therapy When It Is Initiated Soon After Menopause. American Journal of Epidemiology Advance Access published online on May 25, 2009.)

Hormoner kan ge kvinnor ökad risk att dö i lungcancer
dagensmedicin.se 1.6.2009
Data från den omtalade WHI-studien visar att kvinnor som får hormonersättning får ökad risk att dö i lungcancer. (...)

Lågpotenta östrogenpreparat kan öka risken för cancer
lakemedelsvarlden.se 28.4.2009
Även läkemedel med låga halter av östrogen ökar risken för att drabbas av livmodercancer visar en svensk studie. Detta är tvärtemot vad man tidigare trott då enbart höga halter av östrogen bedömts som riskfyllda.

HORMONER Förskrivningen av preparat med höga halter av östrogen har minskat de senaste åren efter att studier visat att de medför en påtaglig ökad risk att drabbas av livmodercancer. Istället har allt fler kvinnor behandlats med så kallade lågpotenta östrogenpreparat. Dessa har ansetts vara mer eller mindre riskfria. (...)

Nu presenteras en skånsk studie som omfattar 40 000 kvinnor mellan 25 och 64 år att även behandling med låga doser östrogen ökar risken för livmodercancer med det dubbla.

- Uppfattningen har varit att de är i princip ofarliga och läkare har förskrivit dem brett, men i vår studie såg vi att de ökade risken lika mycket som de högpotenta, säger Elisabeth Epstein, läkare vid kvinnokliniken på Universitetssjukhuset i Lund och en av forskarna bakom studien. (...)

Breast-cancer risk falls after hormones halted
seattletimes.nwsource.com 5.2.2009
Quitting combination hormone therapy rapidly lowers a woman's risk of breast cancer, according to a new analysis of the massive Women's Health Initiative clinical trial. What's more, taking Prempro, an estrogen-progestin drug, for five years doubled a woman's risk of breast cancer. The paper, in The New England Journal of Medicine, was co-authored by researchers at the Fred Hutchinson Cancer Research Center in Seattle. (...)

Study makes stronger case HRT causes breast cancer
reuters.com 4.2.2009
WASHINGTON (Reuters) - Researchers looking into the long-term health effects of hormone replacement therapy said on Wednesday they had made the strongest case yet that the pills raise the risk of breast cancer.

But other experts and one company that makes hormone replacement therapy (HRT) pills said they still dispute the conclusion that a recent drop in U.S. breast cancer cases means that HRT was responsible for the disease. (...)

HRT Brings Modest Reduction in Brain Volume (Hormonterapi forårsaker moderat reduksjon i hjernevolum)
medpagetoday.com 12.1.2009
BALTIMORE, Jan. 12 -- Postmenopausal hormone therapy is associated with brain atrophy but not cerebrovascular lesions, researchers found.

Hormone replacement therapy was associated with significantly lower volume of the frontal lobe (P=0.004) and hippocampus (P=0.05) and a trend for lower total brain volume (P=0.07) in women 65 and older, Susan M. Resnick, of the National Institute on Aging Biomedical Research Center here, and colleagues reported in the Jan. 13 issue of Neurology. (...)

(Anm: Postmenopausal hormone therapy and regional brain volumes: The WHIMS-MRI Study. Neurology 2009; 72: 135-142.

Postmenopausal hormone therapy and subclinical cerebrovascular disease: The WHIMS-MRI Study. Neurology 2009; 72: 125-134.)

Stort antal danske kvinder får farlig hormonbehandling
pharmadanmark.dk 5.1.2009
Mange danske kvinder over 40 år får hormonbehandling, der fordobler risikoen for brystkræft. Det viser tal fra Lægemiddelstyrelsen. Kommunallæge Vibeke Manniche mener, at medicinen skal afregistreres, men bestyrelsesmedlem i Praktiserende Lægers Organisation Bodil Johnsen er uenig.

Hormonbehandling for kvinder i forbindelse med generne i overgangsalderen medfører en dobbelt så stor risiko for brystkræft, som for kvinder der ikke modtager hormonbehandling, viser en amerikansk undersøgelse.

- Jeg så gerne, at man afregistrerede medicinen. Jeg kan slet ikke se, hvad vi skal med en medicin, der har så alvorlige bivirkninger hos raske kvinder, siger kommunallæge Vibeke Manniche. Hun siger videre, at man tidligere har troet at hormonbehandling havde en positiv påvirkning på bl.a. knogleskørhed og hjertekarsygdomme, men at det altså også har vist sig ikke at være rigtigt.

ibeke Manniche påpeger desuden, at generne i overgangsalderen kan mindskes og eventuelt undgås, hvis kvinder i overgangsalderen motionerer, spiser sundt og holder sig slanke, og at overgangsalderen derved ikke bør kategoriseres som en sygdom. (...)

Undersøgelse: Hormoner fordobler brystkræft-risiko
berlingske.dk 15.12.2008
Brugen af hormoner i overgangsalderen fordobler risikoen for brystkræft, fastslår stor amerikansk undersøgelse endegyldigt efter års debat for og imod hormon-tilskud.

Kvinder, der i mere end fem år spiser hormonpiller for at lette generne i overgangsalderen, har dobbelt så stor risiko for at få brystkræft.
Det viser en ny stor amerikansk undersøgelse, som kaldes det mest ”dramatiske bevis” for faren ved de stadigt populære piller. (...)

Greater parity, HRT use tied to knee and hip replacement
hmetoday.com/reuters 31.10.2008
NEW YORK (Reuters Health) - Increasing parity, younger age at menarche, and use of hormone replacement therapy (HRT) are associated with higher incidence of osteoarthritis requiring joint replacement, according to data from a large, prospective cohort study of middle-aged women in the UK.

The findings come from the Million Women Study, involving 1.3 million women recruited in 1996-2001 at a mean age of 56 years. During an average followup of 6 years, approximately 12,000 women had a primary total hip replacement and 10,000 had a primary total knee replacement. (...)

Oral estrogen therapy in postmenopausal women is associated with loss of kidney function
Kidney Int. 2008 Aug;74(3):370-6. Epub 2008 May 21
(...) Our study shows an independent association in a dose-dependent manner of estrogen use and loss of kidney function in this elderly population. (...)

Gallbladder disease and use of transdermal versus oral hormone replacement therapy in postmenopausal women: prospective cohort study
BMJ 2008;337:a386 (10 July)
(...) Conclusion Gallbladder disease is common in postmenopausal women and use of hormone replacement therapy increases the risk. Use of transdermal therapy rather than oral therapy over a five year period could avoid one cholecystectomy in every 140 users. (...)

Fall in hormone replacement therapy associated with fall in breast cancer (Redusert bruk av hormonterapi knyttet til færre tilfeller av brystkreft)
BMJ 2008;336:1330-1331 (14 June)
A sudden fall in the use of hormone replacement therapy (HRT) in Australia has been associated with a drop in the incidence of breast cancer among older women, a study has shown (Medical Journal of Australia 2008;188:641-4).
A 40% decline in HRT prescribing between 2001 and 2003 was associated with a 6.7% fall in the incidence of breast cancer standardised for age in women aged 50 and older.

Women younger than 50 showed no significant change in incidence of breast cancer, the researchers found.

The fall in sales of HRT followed negative publicity arising from the women’s health initiative study, published in 2002 (JAMA 2002;288:321-33). (...)

Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis
BMJ 2008;336:1227-1231 (31 May)
(...) Conclusion Oral oestrogen increases the risk of venous thromboembolism, especially during the first year of treatment. Transdermal oestrogen may be safer with respect to thrombotic risk. More data are required to investigate differences in risk across the wide variety of hormone regimens, especially the different types of progestogens. (...)

Oral hormone therapy pills double clot risk: study
reuters.com 24.5.2008
LONDON (Reuters) - Menopausal women who take hormone-replacement therapy pills more than double their risk of developing a potentially fatal blood clot, French researchers said on Friday.

The review of 17 studies suggested that the risk was also significantly higher during the first year of treatment, they reported in the British Medical Journal. (...)

HRT Ups Risk of Stroke
ivanhoe.com 30.4.2008
(Ivanhoe Newswire) -- Hormone replacement therapy (HRT) may be putting women at increased risk for stroke, despite the type of hormones they receive or when they begin taking them.

Those conclusions come from researchers who studied women taking part in the Nurses’ Health Study, which has been gauging health concerns among women since 1976. The women in this study were followed from the beginning of the trial until 2004. (...)

Hormone Therapy Linked to Stroke Regardless of Timing
medpagetoday.com 28.4.2008
Women who used estrogen alone had an increased stroke risk of almost 40% compared with the risk faced by women who didn't use hormones, and when estrogen was combined with progestin, the risk increased by 27%, Francine Grodstein, Sc.D., of the Harvard School of Public Health, and colleagues reported in the April 28 issue of Archives of Internal Medicine.

Their analysis of data from the 121,700-woman Nurses' Health Study showed that, for women ages 50 through 54, the attributable risk was about two additional cases of stroke per 10,000 women per year taking hormones. (...)

Estrogen linked to benign lumps (Østrogen linket til godartede svulster)
seattletimes.nwsource.com 9.4.2008
WASHINGTON — Add another risk to hormone therapy after menopause: Benign breast lumps.

One type of hormone therapy — estrogen plus progestin — already is well-known to increase the risk of breast cancer. But a major study of women able to use estrogen alone didn't find that link.

Tuesday, researchers reported a new wrinkle: Those estrogen-only users doubled their chances of getting noncancerous breast lumps. That's a concern not only because of the extra biopsies and worry those lumps cause, but because a particular type — called benign proliferative breast disease — is suspected of being a first step toward developing cancer 10 years or so later. (...)

HRT ökar risken för återfall i bröstcancer
lakemedelsvarlden.se 28.3.2008
Förutom att öka risken för bröstcancer hos friska kvinnor är det nu bekräftat att hormonersättningsterapi, HRT, även ökar risken för återfall hos kvinnor som tidigare behandlats för bröstcancer. Det visar en ny europeisk studie. (...)

Ny varningsflagg för hormonersättning
lakemedelsvarlden.se 5.3.2008
Hormonersättning med östrogen och progesteron vid klimakteriet kan öka risken för cancer även flera år efter att behandlingen avslutats. Den slutsatsen drar forskare efter att ha följt upp de kvinnor som ingått i den stora kända studien Women´s Health Initiative. (...)

(Anm: Health Risks and Benefits 3 Years After Stopping Randomized Treatment With Estrogen and Progestin. JAMA. 2008;299(9):1036-1045.)

Hormone Hazards
newsweek.com 15.1.2007
A new study finds even short-term use of a menopausal therapy may increase the risk of breast cancer. (...)

Gir femdoblet kreftfare
nrk.no 30.1.2008
Drikker du over 14 enheter alkohol ukentlig ved siden av å ta hormoner, er du fem ganger mer utsatt for å få brystkreft. (...)

Hormone replacement therapy quadruples risk of breast cancers
BMJ 2008;336:116 (19 January)
Postmenopausal women taking combined oestrogen and progestin hormone replacement therapy for three years or longer run four times the risk of developing lobular breast cancer, finds US research. This is shorter than the time associated with an increased risk of other types of breast cancer (Cancer Epidemiology, Biomarkers & Prevention 2008;17:43-50). (...)

Hormones raise breast cancer risk quickly: study
reuters.com 15.1.2008
WASHINGTON (Reuters) - Hormone replacement therapy can raise the risk of an uncommon type of breast cancer fourfold after just three years, U.S. researchers reported on Monday.

They found women who took combined estrogen/progestin hormone-replacement therapy for three years or more had four times the usual risk of lobular breast cancer.

Their study, published in the January issue of Cancer Epidemiology, Biomarkers and Prevention, is one of dozens trying to paint a clearer picture of what dangers might come from taking HRT to treat menopause symptoms. (...)

The Estrogen Elixir: A History of Hormone Replacement Therapy in America
NEJM 2007; 357:1670-1671 (October 18)
By Elizabeth Siegel Watkins. 351 pp. Baltimore, Johns Hopkins University Press, 2007. $45. ISBN 978-0-8018-8602-7.
Much has been written about postmenopausal estrogen therapy. No other prescription medication has had such successful promotion to patients and physicians, such widely debated opinions about its use, or such striking ups and downs in the number of prescriptions filled. (...)

Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women
BMJ, doi:10.1136/bmj.39266.425069.AD (published 11 July 2007)
(...) Conclusions Hormone replacement therapy increases cardiovascular and thromboembolic risk when started many years after the menopause. The results are consistent with the findings of the women's health initiative study and secondary prevention studies. Research is needed to assess the long term risks and benefits of starting hormone replacement therapy near the menopause, when the effect may be different. (...)

Estrogen May Be Brain-Booster
healthfinder.gov 29.6.2007
Monkey study suggests it keeps mental decline at bay (...)

For the study, published in this week's online issue of the Proceedings of the National Academy of Sciences, researchers at Mount Sinai School of Medicine, in New York City, removed the ovaries of four distinct groups of female rhesus monkeys. One group included old monkeys that received estrogen; a second group included old monkeys that did not receive estrogen; and there were two other groups of young monkeys that either received or did not receive estrogen. (...)

Study: Estrogen may help arteries of women in their 50s
usatoday.com 21.6.2007
Estrogen pills reduce the amount of calcified plaque in the coronary arteries of postmenopausal women in their 50s, a finding that should reassure women who need to take the hormone for relief of moderate to severe hot flashes, say the authors of a study out today.

The amount of calcified plaque foreshadows future risk of heart attacks. Still, no postmenopausal woman should take estrogen solely to protect her heart, the authors say. (...)

Breast cancer fell when women stopped hormone replacement, US study shows (Mindre bryskreft da kvinner stanset hormonbehandling, ifølge amerikansk studie)
BMJ 2007;334:866 (28 April)
Incidence of breast cancer in 2003 in US women aged 50 or older dropped by 6.7%, a year after many women stopped using hormone replacement, says a report in the New England Journal of Medicine (2007;356:1670-4, http://content.nejm.org/cgi/content/abstract/356/16/1670).

Women's use of hormone replacement fell substantially after the Women's Health Initiative study showed an increased risk of cardiovascular events and breast cancer in women using a combination of oestrogen and progestogen called Prempro (JAMA 2002;288:321-33, 366-8). (...)

Hormonersättning ökar risken för äggstockscancer
Läkemedelsvärlden 2007(4) (April)
HORMONER Resultaten som presenteras online på Lancet idag bygger på den brittiska Million Women Study. Studien har följt nästan en miljon kvinnor under sju år, trettio procent av dessa använde fortfarande hormonersättning och tjugo procent var tidigare användare. Den andra hälften hade inte fått någon hormonersättning alls. Och resultaten visar en tjugo procents relativ riskökning att drabbas av äggstockscancer för de kvinnor som gått på hormonersättning längre än fem år. I det stora patientunderlaget innebär det ett extra fall av äggstockscancer på 2500 patienter, och ett extra dödsfall på 3300 patienter.

Kvinnor som äter hormonersättningspreparat har en förhöjd risk att drabbas av äggstockscancer visar en stor studie. Men resultaten är inte övertygande.
- Jag ställer mig avvaktande, säger Marie Bixo, docent vid institutionen för obstetrik och gynekologi vid Norrlands universitetssjukhus. (...)

Mer om alkohol og brystkreft
Notiser
Tidsskr Nor Lægeforen 2007; 127 (19.4.2007)
Resultater fra den store amerikanske studien av kvinners helse (The Women's Health Study) bekrefter at det er en positiv assosiasjon mellom alkoholkonsum og risiko for brystkreft (Am J Epidemiol 2007; 165: 667 - 76).

Kvinner som drakk én alkoholenhet daglig (10 g), hadde omkring 10 % økt risiko, mens de som drakk tre enheter eller mer, hadde omkring 40 % økt risiko for brystkreft.

Resultatene tyder på at alkohol bare er forbundet med østrogen- og progesteronreseptorpositiv brystkreft. Dermed støttes hypotesen om en direkte effekt mediert gjennom kvinnelige kjønnshormoner. (...)

Two studies link hormones and cancer in women
reuters.com 19.4.2007
Thu Apr 19, 2007 8:19 AM ET
By Maggie Fox, Health and Science Editor
WASHINGTON (Reuters) - Two studies published on Wednesday further link hormone replacement therapy with cancer, suggesting -- but not yet proving -- that HRT causes breast and ovarian cancer. (...)

Breast Cancer Incidence Stayed Low After HRT Decline
medpagetoday.com 18.4.2007
HOUSTON, April 18 -- Evidence linking a decrease in the annual incidence of breast cancer to a decline in hormone replacement therapy is as robust as first reported, investigators here said.

As Peter Ravdin, M.D., Ph.D., of the University of Texas M.D. Anderson Cancer Center, and colleagues reported at the San Antonio Breast Cancer Symposium last December, the incidence fell 7% from 2002 to 2003, reversing a 20-year trend. (...)

And now, in an extended analysis of their previous study, Dr. Ravdin, and colleagues, showed that the breast cancer incidence was unchanged from 2003 to 2004, indicating that the decline they had previously seen was not a statistical fluke, they reported in the April 19 issue of the New England Journal of Medicine.

"This kind of study can't prove causality, but the data present a very compelling link between hormone replacement therapy and breast cancer," said co-author Donald Berry, Ph.D., also of M.D. Anderson. (...)

Wyeth Loses Prempro Trial, Ordered to Pay $1.5 Million in Damages (Wyeth taper Prempro rettssak, dømt til å betale 1,5 millioner dollar i skadeerstatning)
cnbc.com 29.1.2007
A state jury in Philadelphia on Monday found Wyeth's hormone replacement therapy (HRT) Prempro was responsible for a woman's breast cancer and ordered the U.S. drugmaker to pay $1.5 million in compensatory damages, a court official said. (...)

Falsk østrogenalarm
dagbladet.no 2.1.2007
Ole-Erik Iversen Professor og overlege ved Kvinneklinikken, Haukeland Universitetssykehus
HORMONER: Sissel Benneche Osvold inviterer til ny «alarmrunde» om østrogen i Dagbladet 22.12. Jeg føler behov for å svare fordi innlegget nok ikke intenderer å oppdatere evidensgrunnlaget, men heller «hva sa jeg». (...)

JEG VAR MED i den gruppen i Statens legemiddelverk som oppdaterte anbefalingene i 2003. I realiteten ble indikasjonene for behandling helt uendret, men omtalen av forebyggende effekter og samlet nytte- kostnadsvurdering ble endret. (...)

Hormones and Cancer: Assessing the Risks
nytimes.com 26.12.2006
When researchers reported recently that a precipitous drop in breast cancer rates might be explained by a corresponding decrease in the use of hormones for menopause, women reacted with shock, anger and, in some cases, profound relief that they had never taken the drugs. (...)

Østrogenalarm
dagbladet.no 22.12.2006
I 2002 viste en amerikansk sjokkrapport at østrogenbehandling mot overgangsalderens plager økte faren for brystkreft langt sterkere enn antatt. I løpet av seks måneder falt østrogenbruken med 50 prosent. Fram til 2003 sank brystkreftantallet med 15 prosent i USA. (...)

ANDRE STUDIER viser at østrogener heller ikke hjelper mot hjertesykdom hos kvinner i overgangsalderen, men kan forverre tilstanden. (...)

FDA must do more to monitor side effects
roanoke.com 18.12.2006
Hormone replacement therapy, prescribed to lessen the symptoms of menopause, apparently led to increased incidences of breast cancer.

Scientists never say things with such certainty, but it's possible that about 14,000 women didn't get breast cancer in 2003 because they paid attention to a study linking hormone treatments for menopause symptoms to the disease.
After that study was publicized, millions of women quit taking the hormone replacements, which had been routinely prescribed to ease symptoms of menopause.

The sale of one drug, Prempro, fell by 50 percent. (...)

Færre med brystkreft
vg.no 15.12.2006
Sammenhengen mellom hormonbehandling ved overgangsalder og brystkreft kan være svært stor, viser en ny undersøkelse. Dramatisk, mener norsk lege.

Da millioner av kvinner sluttet med hormonbehandling for overgangsalderen, falt antall brystkrefttilfeller i USA dramatisk.

Antall tilfeller av den vanligste formen for brystkreft i USA falt med hele 15 prosent fra august 2002 til desember 2003, viser en ny rapport fra National Cancer Institute. Generelt sett falt forekomsten av brystkreft med sju prosent. (...)

Breast Cancer Drop Brings Relief
cbsnews.com 15.12.2006
The naysayers were many when a big study in 2002 said menopause hormones raised the risk of breast cancer and caused millions of women taking the pills to stop.

Hormones had been prescribed for decades in the belief that they helped ward off heart problems, dementia and a host of other ills beyond curing hot flashes. Many doctors and women, too, were reluctant to buy the new study's conclusions.

Now there is more evidence that hormones and breast cancer are linked. (...)

Reversing Trend, Big Drop Is Seen in Breast Cancer
nytimes.com 15.12.2006
Rates of the most common form of breast cancer dropped a startling 15 percent from August 2002 to December 2003, researchers reported yesterday. (...)

The reason, they believe, may be because during that time, millions of women abandoned hormone treatment for the symptoms of menopause after a large national study concluded that the hormones slightly increased breast cancer risk.

The new analysis of breast cancer rates, by researchers from the M. D. Anderson Cancer Center in Houston and presented at a breast cancer conference in San Antonio, was based on a recent report by the National Cancer Institute on the cancer’s incidence. (...)

Breast Cancer Incidence Among U.S. Women Drops 7%, Linked to Decrease in HRT Use, Researchers Say
kaisernetwork.org 15.12.2006
Public Health & Education (...)

Wyeth drug caused breast cancer in women, says jury
pharmatimes.com 5.10.2006
A woman who claimed that Wyeth's hormone replacement therapy product Prempro was the cause of her breast cancer has won $1.5 million in compensatory damages in a case heard in Philadelphia, USA.

In the first federal Prempro trial, a jury in Little Rock, Arkansas, concluded last month that Wyeth was not negligent and had adequately warned patients and doctors of the cancer risk associated with the drug. Wyeth is facing more than 5,000 lawsuits involving its HRT products. (...)

Analysts have suggested that Wyeth has a strong case in showing that it was not negligent, as it changed the labelling for PremPro very quickly after data emerged on the risk of breast cancer with the drug.

Wyeth's stock plunged by more than a quarter in 2002 after a major US government-led study found Prempro was associated with an increased risk of breast cancer, coronary heart disease and stroke. The study, which was due to run until 2005, was terminated at an average follow up of 5.2 years after investigators observed a 26% increase in breast cancer, a 41% rise in strokes and a 29% increase in heart attacks. (...)

Long Term Estrogen Therapy Linked to Breast Cancer
healthfinder.gov 8.5.2006
Finding supports guidelines on hormone therapy for menopause, expert says. (...)

Chen's team believes the effect of estrogen is cumulative. "We found that there was a 42 percent increased risk for all types of breast cancer for women who had used estrogen alone for 20 or more years," she said. However, for the type of breast cancer that is hormone sensitive, there was a 48 percent increased risk after 15 years of estrogen use, she said.

The study findings appear in the May 8 issue of the Archives of Internal Medicine.

Estrogen, progestin questioned
usatoday.com 12.4.2006
COMPARING THE TWO
Long-term estrogen use is less risky than long-term estrogen plus progestin use in postmenopausal women. For example:

Estrogen alone
-- Breast cancer risk remains same as non-users for up to seven years of treatment.

-- Users are about 50% more likely to get blood clots than non-users.

Estrogen plus progestin
-- Breast cancer risk begins to rise after three or four years of use.

-- Users are twice as likely to get blood clots as non-users.

Source: WHI (...)

Surprising turn in hormone therapy research
usatoday.com 12.4.2006
THEN AND NOW

• September 1993: Women's Health Initiative begins to recruit more than 161,000 postmenopausal women.
• June 2002: The estrogen-plus-progestin trial stops because of increased risk of breast cancer, heart attacks, strokes and blood clots.
• May 2003: Researchers report estrogen plus progestin doubles the dementia risk in women 65 and older.
• March 2004: Estrogen-only trial is halted because of stroke risk.
• February 2006: Final heart disease data from estrogen-only study show no overall heart-health benefit, contrary to long-held beliefs.
• April 2006: Two studies released: Estrogen raises older women's risk of blood clots 32%. But final breast cancer data show no increased risk overall from taking estrogen alone. (...)

Although they had no more breast tumors, women on estrogen had 50% more abnormal mammograms requiring follow-up and 33% more biopsies. The estrogen group had 747 biopsies, the placebo group, 549.

"What is worse? A hot flash or a stroke, more mammograms or more breast biopsies?" Stefanick said. "That's the kind of discussion a woman has to have with her physician."

Study: Estrogen-Only Pills Pose Risk
latimes.com 10.4.2006
— Estrogen pills raise older women's risk of blood clots, but not as much as supplements that also contain progestin, according to new data from a landmark government study on more than 10,000 women.

The study is the most rigorous to date to link estrogen-only pills with blood clots in healthy women past menopause. (...)

The newly released data involves a wider variety of blood clots than those that cause strokes.

The research involved 10,739 women ages 50 to 79 with hysterectomies. Those who took estrogen pills were 32 percent more likely to develop blood clots, mostly in the legs, than those on dummy pills. Estrogen-only pills can increase the risk of uterine cancer and are advised only for women without wombs.

Over about seven years, 111 women on estrogen developed blood clots, compared with 86 on dummy pills. The risk was highest in the first two years on hormones.

The study appears in Monday's Archives of Internal Medicine. (...)

ACP: One Woman in Four Can't Kick Hormone Habit
medpagetoday.com 9.4.2006
Explain to patients who ask that a significant number of women will have severe rebound symptoms when they attempt to stop hormone therapy.

Inform patients who ask that some practical approaches, including avoiding turtlenecks, sweaters, hot drinks, and spicy foods, may reduce menopause symptoms. (...)

Doubts About Calcium
washingtonpost.com 28.2.2006
Calcium and vitamin D supplements -- long recommended for post-menopausal women as a way to protect their bones -- were found not to reduce the risk of hip fractures in a large, closely watched study published this month. This has left some women confused about the value of taking the pills.

The Women's Health Initiative (WHI), a 15-year federally funded study involving more than 36,000 women ages 50 to 79, found that taking calcium (1,000 milligrams daily) and vitamin D (400 international units daily) improved hip bone density, but didn't decrease the risk of hip fractures. (See Quick Study, Page F6.) While the findings may influence the direction of future studies, researchers admit they offer limited practical guidance for physicians and patients.

How should women respond meanwhile? We put that question -- and others -- to experts last week.

Am I the only one confused by the new findings?

Økt brystkreftrisiko ved hormonbehandling
Tidsskr Nor Lægeforen (22.2.2006)
Kvinner som får hormonbehandling med østrogen-gestagen etter klimakteriet har økt risiko for visse typer brystkreft sammenliknet med kvinner som ikke får slik behandling.

Dette viser en studie publisert i tidsskriftet Breast Cancer Research, hvor over 2 200 kvinner med brystkreft, samt en kontrollgruppe på over 3 000 kvinner, alle i alderen 50-74 år, var inkludert. Forskere ved Karolinska Institutet i Stockholm og Genome Institute i Singapore står bak studien.

Det er allerede kjent at kombinasjonsbehandling med østrogen og gestagen i mer enn fem år øker risikoen for brystkreft, men denne studien viser at risikoen øker mer for visse typer brystkreft enn for andre.

Hormonforsøg blandt kvinder standset i utide
politiken.dk 19.2.2006
Præparat, som bruges af 5.700 danske kvinder, har vist sig at give en overrisiko for blodpropper i hjernen og hjerneblødninger. (...)

Et multinationalt forsøg med hormonpræparatet Livial er standset i utide, fordi stoffet har vist sig at medføre en forøget risiko for slagtilfælde.

Livial bruges til behandling af gener hos kvinder i og efter overgangsalderen, men det anvendes også - i lighed med andre hormonpræparater - til at forebygge knogleskørhed.

5.700 danske kvinder var sidste år i behandling med præparatet. (...)

Hormoner frarådes
Et dansk forsøg med andre hormoner som forebyggelse af knogleskørhed blev for godt to år siden standset af etiske grunde, fordi det også viste en overrisiko for brystkræft.

Siden er Lægemiddelstyrelsen gået bort fra at anbefale hormonbehandling som førstevalg til forebyggelse af knogleskørhed, netop på grund af de mange meldinger om bivirkninger.

»Det kan da godt undre mig, at man har fortsat et forsøg med hormoner i forbindelse med knogleskørhed«, siger professor, overlæge Leif Mosekilde, der stod bag det forsøg, som blev stoppet i 2003.

Forebygger knogleskørhed
Det forsøg, som nu er indstillet, skulle netop vise, om Livial kan forebygge nye knoglebrud i rygsøjlen hos kvinder, der allerede har knogleskørhed.

Det kan det ifølge de foreløbige resultater, der viser en halvering i antallet af nye knoglebrud hos de kvinder, der fik det aktive stof - sammenlignet med den gruppe, der fik placebo (snydepiller, red.). Men samtidig viste det mere end en fordobling af antallet af slagtilfælde - blodpropper i hjernen eller hjerneblødninger - i Livialgruppen sammenlignet med placebo-gruppen.

'Små tal'
4.538 kvinder i flere lande har deltaget i forsøget, heriblandt cirka 500 danske, oplyser overlæge i Lægemiddelstyrelsen Doris I. Stenver.

»Der er tale om små tal for slagtilfældene i forsøget«, siger Doris Stenver:

»Det drejer sig om 25 kvinder blandt dem, der fik det aktive stof, mod 11 i placebo-gruppen. Alligevel har man valgt at standse forsøget, fordi den positive effekt på knogleskørhed ikke skønnes at opveje den øgede risiko for bivirkninger«.

Doris Stenver oplyser, at forsøgspersonernes gennemsnitsalder var 68 år, og at der således var tale om ældre kvinder, der i forvejen har en overrisiko for slagtilfælde.

Færre kvinder får hormoner mod overgangsalderen
politiken.dk 14.2.2006
Mange stopper, og andre lader helt være med at begynde på hormonerne i forbindelse med overgangsalderen, viser analyse.

De danske kvinder har i stor stil droppet hormonerne i forbindelse med overgangsalderen.

Siden 2002, hvor forbruget toppede, er antallet af kvinder, som spiser hormoner, reduceret med 32 procent. Det svarer til næsten 60.000 færre kvinder i behandling.

I dag er hver ottende kvinde over 40 år i hormonbehandling, mens det tidligere var næsten hver femte. (...)

Risiko for blodpropper
Især undersøgelser, der viser en forøget risiko for brystkræft ved hormonbehandling, har været meget omtalt.

Men hormonerne har også vist sig at øge risikoen for blodpropper i hjerne, hjerte, ben og lunger, og en enkelt undersøgelse har vist en let forøget risiko for demens hos kvinder over 65 år.

»I det hele taget har den tidligere tro på de gunstige virkninger af hormonbehandling i forbindelse med overgangsalderen nok været stærkt overdrevet«, siger overlæge Iben Holten, Kræftens Bekæmpelse, som bl.a. forsker i brystkræft.

Godt alternativ
Lægemiddelstyrelsen har i analysen fulgt de kvinder, som i første halvdel af 2002 har indløst mindst én recept på hormoner. Ved udgangen af juni måned sidste år var halvdelen af dem ikke længere i behandling. Det er især de yngre kvinder i denne gruppe, som har droppet hormonerne.

Samtidig med, at det samlede forbrug af hormoner er faldet drastisk, er der sket en næsten fordobling af forbruget i form af stikpiller til vaginal behandling. Stikpillerne virker mod tørhed i skeden, der er en almindelig gene hos kvinder i og efter overgangsalderen, men de virker ikke på hedeture.

»Det kan være et godt alternativ til at spise hormoner«, siger Iben Holten. »Stikpillerne virker kun lokalt, og der går ikke så meget over i kroppen«.

Risiko for brystkræft
Iben Holten har ingen betænkeligheder ved at anbefale stikpillerne, hvis man har problemer med tørhed i skeden. Der er dog et lille forbehold.

En enkelt undersøgelse har vist, at også den lokale behandling kan indebære en lille risiko for kvinder, der allerede har haft brystkræft. Nedgangen i brugen af hormoner er især sket i perioden fra sommeren 2003 og frem til 2005. Herefter ligger brugen nogenlunde stabilt.

Rethinking Hormones, Again
nytimes.com 31.1.2006
Candace Talmadge was determined to get through menopause without using hormones, and she tried just about every alternative treatment she could find, like soy tablets, herbs and acupuncture, a chiropractor and even an anti-anxiety medication. (...)

Debates over the study's findings remain heated, with doctors divided between those who believe in the power of hormone therapy to protect the heart and relieve menopausal symptoms and those who think that any heart benefits have been discredited. (...)

"Three years ago, the message was, 'You're going to die if you don't stop taking this,' " said Dr. Minkin, who takes estrogen and is a paid speaker for drug companies that make the estrogen products she prescribes. At the meeting last fall, she said, the feeling was: "Gee, estrogen is pretty good stuff. If you need it for relief, you shouldn't be afraid to take it."

Svåra samtal om hormonbehandling
Läkemedelsvärlden 2005(12) (December 2005)
Riskerna med hormonbehandling bedöms olika av läkarna och de kvinnor som söker hjälp mot klimakteriebesvär. Hos kvinnor i 50-årsåldern blev attityden till sådan behandling mer negativ i början på 2000-talet, sedan ny forskning visat sämre effekt och fler biverkningar än tidigare.

HORMONERSÄTTNING Mikael Hoffmann, doktorand vid avdelningen för klinisk farmakologi, Linköpings universitet, har jämfört två enkätundersökningar gjorda 1999 och 2003 på samtliga Linköpingskvinnor som under åren fyllde 53 och 54 år. Det visade sig att attityden till hormonbehandling svängde kraftigt under åren.

1999 ansåg fyra av fem att hormonbehandling hade god effekt, medan en av åtta bedömde riskerna för allvarliga biverkningar som höga eller mycket höga. Fyra år senare var det bara två av tre som trodde att metoden gav god effekt, och var fjärde som bedömde riskerna som höga eller mycket höga. (...)

Enligt ett pressmeddelande illustrerar avhandlingen betydelsen av en djupare förståelse av begreppet risk för att åstadkomma en god dialog kring olika behandlingsalternativ.

Mikael Hoffmann försvarar din avhandling, Risk talk – on communicating benefits and harms in health care, idag fredag den 27 januari vid Hälsouniversitetet i Linköping.

Hormone Suits Face Hurdle as Drugs Keep FDA Backing
Los Angeles Times 7.11.2005
A study linking the menopausal aids to health risks has led to 3,600 suits. But the pills' continued sale may add to the burden of proof.

The bad news came on July 9, 2002: Scientists had abruptly halted a major study of hormone-replacement drugs for menopausal women after finding links to breast cancer and blood clots. (...)

Santa Monica gynecologist Karen Blanchard remembers that summer as "horrible. We received at least 20 calls a day from hysterically upset patients, and many, many women stopped taking hormones."

Next, following a now-familiar pattern, came the lawyers. Over the last three years, some 3,600 cases have been filed against Wyeth, Upjohn, Pfizer Inc. and other companies over estrogen drugs women took to ease menopausal symptoms.

But somewhere along the line, this controversy departed from the usual script: The hormone medication — unlike other drugs that have inspired waves of litigation, such as Wyeth's "fen-phen" and Merck & Co.'s Vioxx — is still on the market. It's still approved by the Food and Drug Administration as safe and effective.

Kvinder dropper hormoner i overgangsalderen
Berlingske Tidende 5.11.2005
Frygten for at få brystkræft afholder kvinder fra at tage hormonpiller i overgangsalderen. Mange kvinder lider unødigt af hedeture og andre gener.

Forbruget af hormonpiller til kvinder i overgangsalderen styrtdykker. Risikoen for at udvikle brystkræft får mange til helt at fravælge hormonerne eller kun tage dem i en kort periode, viser nye tal fra Lægemiddelstyrelsen. Kræftens Bekæmpelse glæder sig over udviklingen.

- Det er positivt, at danske kvinder er blevet mere opmærksomme på bivirkningerne, og at de kvinder, som vælger pillerne, hurtigere holder op, siger seniorforsker i Kræftens Bekæmpelse Anne Tjønneland.

Ifølge en opgørelse fra Lægemiddelstyrelsen blev der i 1. halvår af 2005 solgt cirka 18 millioner døgndoser hormonmedicin til kvinder i overgangsalderen, mens forbruget i første halvår af 2003 var oppe på næsten 30 millioner.

Estrogen Not Effective After Menopause
Washington Post 26.9.2005

Hormones Weather 'the Change'
Washington Post 20.9.2005
Three Years After a Landmark Study Hammered Sales, Use of Hormone Therapy for Menopause May Be Inching Up

As president and chief executive officer of the Society for Women's Health Research, Phyllis Greenberger knows all about the studies showing that women who take hormones after menopause have a greater risk of breast cancer, stroke, heart attack, incontinence and dementia. She is aware that federal health officials recommend that the drugs be taken at the lowest dose for the shortest time possible to treat severe symptoms of menopause such as hot flashes. (...)

"I feel better, I have no side effects and in my case I see no downside," she said, noting that estrogen protects against osteoporosis and colon cancer. "Obviously if I thought it was dangerous, I wouldn't be taking it," Greenberger said.

Study Raises Doubts About Hormone Therapy for Women (Studie reiser tvil om hormonterapi for kvinner.)
Washington Post 13.7.2005
Mer enn halvparten av kvinner som begynte med hormonterapi for å stanse ubehagelige varmetokter og nattlig svette erfarte igjen symptomer med en gang de stanset inntaket av legemidlene, rapporterte en studie i Journal of the American Medical Association reported i går. (More than half of women who began hormone therapy to stop uncomfortable hot flashes and night sweats experienced those symptoms again once they stopped taking the drugs, a study in the Journal of the American Medical Association reported yesterday.)

Bruk av data fra en statlig studie av kvinners helse, fant forskerne at den forsinkede effekt opptrådte hos både yngre og eldre kvinner, inklusive de nær 70. Forskerne rådet leger å undersøke alternative måter å behandle menopausale symptomer. (Using data from a federal study of women's health, the researchers found that the delayed effect occurred in both younger and older women, including those nearing 70. The researchers advised doctors to explore alternative ways to treat menopausal symptoms.)

"Før denne studie, visste vi lite om effektene en kvinne erfarer når de plutselig stopper bruk av hormonterapi mot menopause," sa Sherry Sherman ved National Institute on Aging. "Nå efarer kvinner at deres symptomer kunne vende tilbake, også etter bruk av disse hormoner i mer enn fem år." ("Before this study, we knew little about the effects a woman experiences when she suddenly stops menopausal hormone therapy use," said Sherry Sherman of the National Institute on Aging. "Now women are learning that their symptoms might return, even after using these hormones for more than five years.")

Studien så på kvinner i den store Women's Health Initiative study fra Wyeth Pharmaceuticals hormonbehandling med legemidlet Prempro, som ble avbrutt i 2002 etter at den viste at kvinner som tok legemidlet hadde en høyere risiko for kardiovaskulær sykdom og andre mulige alvorlige problemer. Kvinnene i den nye studien var blant de som plutselig stanset behandlingen. (The study looked at women in the large Women's Health Initiative study of Wyeth Pharmaceuticals' Prempro hormone treatment, which was abruptly stopped in 2002 after it showed that women taking the drug were at higher risk of cardiovascular disease and other potentially serious problems. The women in the new study were among those who suddenly stopped the treatment.)

Hormoner fordobler risiko for at dø af brystkræft
Dagens Medicin 17.6.2005
Risikoen for at dø af brystkræft er dobbelt så stor blandt kvinder, der har brugt hormoner i forbindelse med overgangsalderen, som hos kvinder, der aldrig har brugt disse lægemidler.

Det dokumenterer en dansk forskergruppe, som i en ny undersøgelse giver det hidtil mest dystre billede af, hvordan hormonterapi øger risikoen for at dø af brystkræft. For to år siden viste det meget omtalte britiske The Million Women Study som nogle af de første en overdødelighed på ’kun’ 22 pct. mod 97 pct. i denne undersøgelse.

»Det kan skyldes, at vi har fulgt kvinderne længere end de britiske forskere,« siger læge, ph.d. Claudia Stahlberg, Hvidovre Hospital, der har ledet undersøgelsen, som netop er offentliggjort i tidsskriftet International Journal of Epidemiology.

Permanent nedsatt sexlyst
Dagbladet 26.5.2005
En undersøkelse foretatt ved universitetet i Boston tyder derimot på at virkningen kan bli langvarig, om ikke permanent, skriver Times online

- Det er en mulighet for at den typen prevensjon kan gi kvinnene varige mén, sier doktor Goldstein, som står bak rapporten.

Undersøkelsen ble foretatt på 125 unge kvinner som gikk til behandling for problemer tilknyttet seksualitet. Sekstito brukte p-piller, førti hadde gjort det tidligere og tjuetre hadde aldri prøvd den typen prevensjon.

Et lavere testostoronnivå medfører nedsatt sexlyst også for kvinner. Hver tredje måned i løpet av et år målte forskerne nivået på globulin, et stoff som hemmer eller blokkerer effekten av testostoron. De oppdaget at nivået av det blokkerende stoffet var sju ganger høyere hos de som brukte p-piller.

Hos kvinnene som hadde sluttet å bruke p-piller sank globulinnivået, men det forble tre til fire ganger høyere enn hos dem som aldri hadde brukt p-piller. (...)

Skremt til å slutte med østrogen
SYLVI LEANDER ANNE HAFSTAD
aftenposten.no 10.2.2005
Norske kvinner sluttet brått med østrogenpillene mot plager i overgangsalderen etter medieoppslag om skadevirkninger i fjor sommer. Ferske tall viser en nedgang i salget på 15 prosent siste halvår i 2002. Eksperter er bekymret for at kvinner plages unødig. (...)

Overdreven frykt
Ekspertenes råd er klart og tydelig:
- Kvinner som har plager i overgangsaderen bør kontakte lege. All bruk av medisiner er forbundet med en viss risiko. Det vil alltid være en avveining mellom effekt og eventuelle bivirkninger. Det gjelder også bruk av østrogen til kvinner i overgangsalderen. Når det er sagt, kan den amerikanske undersøkelsen ikke overføres til norske forhold. Det er derfor synd at kvinner ble så vettskremt at de sluttet med HRT og nå plages unødig. HRT skal som all annen medisinsk behandling, gis på indikasjon, altså ut fra behov, sier professor Babill Stray-Pedersen ved Kvinneklinikken på Rikshospitalet. (...)

Stray-Pedersen får støtte fra en av våre fremste eksperter på forebyggelse av hjerte- og karsykdommer.

- Debatten rundt bruk av HRT har vært veldig emosjonell, og konklusjonene i den amerikanske studien er trukket ut fra forhold som ikke gjelder i Norge, sier professor Ingrid Os, Institutt for farmakoterapi, Universitetet i Oslo. (...)