STUDY finds low hormone doses for menopause as effective as high doses

Monday, June 4th 2001, 12:00 am
By: News On 6

TRENTON, N.J. (AP) _ A major study funded by the top seller of a hormone therapy for menopause finds low doses of estrogen and progestin worked as well as higher doses, with fewer side effects.

``This is an important advance'' as women and doctors increasingly debate the benefits of hormone replacement therapy, said Dr. Margery Gass, director of the Menopause and Osteoporosis Center at University Hospital in Cincinnati.

``Now we finally have some good evidence that lower doses can be satisfactory for many people,'' she said.

Dr. Wulf Utian, one of the principal investigators, predicted on Monday that low-dose pills now will be given to many women who are just starting hormone therapy or who are bothered by side effects, such as irregular bleeding and breast tenderness.

Women taking hormones without problems ``will do just as well to stay on what they're currently taking,'' added Utian, executive director of the North American Menopause Society.

Roughly a third of American women 50 and older take hormones to control menopause symptoms such as hot flashes, or to cut their risk of osteoporosis.

Two reports on the two-year Women's Health, Osteoporosis, Progestin, Estrogen (Women's HOPE) study appear in the June issue of the journal Fertility and Sterility.

The 57-site study included 2,673 healthy, postmenopausal women who still had their uterus. Some received pills containing the most common estrogen dosage, 0.625 mg a day, with or without 2.5 mg of progestin. Other women were given combinations of progestin and two lower estrogen doses.

One report states that combining 1.5 mg of progestin with 0.45 mg or 0.3 mg of estrogen daily was as effective as higher doses in reducing hot flashes and preventing thinning of the vaginal lining, which causes infections and painful intercourse for many older women.

The other report shows the same low-dose combinations worked about as well as higher doses in preventing ``breakthrough'' bleeding, the main reason many women stop hormone therapy.

Worries that the therapy can increase the risk of breast cancer also may make low doses more appealing.

The research was funded by Wyeth-Ayerst Research, part of American Home Products.

The company makes Premarin, which accounted for about two-thirds of the $1.7 billion in hormone replacement medications sold last year, according to health-care data company IMS Health.

There are currently no low-dose forms of popular hormone pills combining estrogen and progestin, but American Home hopes to sell a version of its Prempro, containing 0.45 mg of estrogen and 1.5 mg of progestin, by year's end.

``It's really good to have the options,'' said Gass, who has been giving patients low doses for a decade, although that required taking two different pills.