On the breakfast table, a few slices of toast and newspapers. A well-known female entrepreneur in Taiwan holds coffee and carefully browses the important news of major newspapers. She always grasps the latest news of the world before going out. But today, she threw the coffee cup on the table in shock.
"The study of hormone therapy, the United States called an emergency stop, and 6 million women were shocked."
Thinking of entering menopause more than ten years ago, the gynecologist next to her took the initiative to prescribe hormone replacement therapy for her, but did not clearly tell her the possible risks of this drug. In the past few years, there has been information showing that hormone supplementation will increase the incidence of breast cancer, but they are all in a state of different doctors talking about each other, so she has not stopped taking the medicine.
She has heart disease and is a high-risk group of breast cancer, but this time she took the weight and became determined, so she stopped taking medicine that night. The people around her cared and asked her, "Can you stop taking the medicine right away?" She replied confidently, "Then tell me, what will happen if you stop taking the medicine?" She felt that she seemed to have been deceived by doctors in the past few years up.
That's the scare a new study has sparked. What does this report say?
A research report published by the National Institutes of Health on July 17 in the Journal of the American Medical Association (JAMA). Taking 16,608 women aged 50 to 79 as the research object, it was found that after 5.2 years of using estrogen and progesterone mixture (the so-called hormone replacement therapy, HRT, Hormone Replacement Therapy), breast cancer The attack rate increased by 26%, heart disease by 29%, stroke by 41%, while hip and other fractures decreased by 24%, and colorectal cancer decreased by 37%. The risk of breast cancer increased significantly after three years of use, while heart disease was detected after one year.
The drug used in this research is Prempo (the trade name in Taiwan is Premarin) produced by Wyeth Pharmaceuticals. The daily dose is 0.625mg of estrogen and 2.5mg of progesterone. Therefore, the findings do not apply to women who only use estrogen.
The final conclusion of the report is: After 5.2 years of using estrogen and progesterone mixture in the menopausal women tested, the overall harm outweighs the benefit. There is no protective effect against primary heart disease.
The results of this study, breaking the original hormone supplement can help women protect the heart, is a newer research results.
The battle between gynecologists and breast surgeons As for breast cancer, it is not a new discovery, but a subject of constant controversy.
Gynecologists who actively use hormone supplementation therapy have always taken a reserved attitude towards "whether hormone supplementation will cause breast cancer".
Yang Zaixing, a gynecologist at the Menopause Clinic of Taipei Veterans General Hospital, said that this report can only be used as a reference, because the mechanisms behind heart disease and breast cancer are complex and there are many risk factors, and hormone replacement therapy may be just one of them.
He also likened that the concentration of hormones in female breasts is quite high, which can be compared to a bottle of mineral water. Female hormones replenished from the outside are only like a drop of water, and their internal effects are actually limited.
In addition, Tsai Ying-mei, chairman of the Taiwan Menopause Medical Association and a professor of obstetrics and gynecology at Kaohsiung Medical University, also pointed out that the average age of breast cancer in Taiwanese women is 48 years old, which is different from the 60-65 years old in the United States. Therefore, whether hormone replacement therapy also increases the risk of breast cancer among Taiwanese women remains to be further studied.
But American breast surgeon Susan. Love has a different observation on this. She believes that the rate of breast cancer among postmenopausal women in Taiwan is lower than that in the United States, because Taiwanese women did not use hormones in the past. It was not common until recently, so of course it is relatively low.
Huang Junsheng, a breast surgeon at National Taiwan University Hospital, also has different worries.
He believes that hormone replacement therapy may have a greater impact on Taiwanese women than on Western women. Because the proportion of American women suffering from breast cancer is relatively high, adding a little risk factor will actually have little effect. However, when the breast cancer of Taiwanese women is relatively low, any change in risk factors will increase their risk, which is like the last kick in the door.
In the face of so many different claims, what should women do?
Taiwan does need further local research, so that doctors and postmenopausal women can follow and make better choices for menopause. Prior to this, Western medication guidelines were probably the only and most important reference.
Why are you taking hormones?
"Mom, are you still taking Prempro? Has your bleeding stopped?" The anxious Ms. Wu asked her mother who lived in Seattle through long-distance calls. "Can I still take it now?" "Should I take it?" "Can I stop taking it?" These are the answers they most want to know.
He Shizhu, director of the Obstetrics and Gynecology Department of the Taichung Veterans General Association, said that facing this research report and confusing information, one should not panic, but should first ask oneself: "Why should I use hormone replacement therapy?"
Is it to relieve the symptoms of menopause? Or want to prevent chronic diseases like heart disease or broken bones? Or do you want to maintain a youthful appearance and use it year after year as a "fountain of youth"? If you think about it and compare it with the suggestions of relevant Western groups, you may be able to get a preliminary answer. After the report was released, relevant societies and research units in the United States have responded to the next "how to use hormones". Night sweats and vaginal dryness. However, long-term use (more than 5 years) is not recommended because it increases the risk of breast cancer and cardiovascular disease. As for the benefits it brings, such as reducing the incidence of fractures and colorectal cancer, there are other alternative drugs or methods, and it is not necessary to use it.
Cai Jizhi, an attending gynecologist at Hexin Hospital, also said that the basic principle of hormone use should be "the less the dose, the better, and the shorter the time, the better." Use it for one year during menopause, and then gradually reduce it until you stop using it, such as once a day. Pieces, turned into one every two days.
If the drug is stopped suddenly, there will be no side effects, but there may be bleeding, which is due to the endometrium peeling off, which is a normal phenomenon. Symptoms of menopausal discomfort may also occur. At this time, it is necessary to discuss with the doctor and gradually stop the drug to relieve the symptoms.
If you want to use hormones for a long time, you must take into account the accompanying risks. Of course, do a complete discussion and examination with your doctor, including family history (breast cancer, cardiovascular disease and diabetes), gynecological consultation, pap smear, liver function test, blood pressure, blood clots and breast examination. During the period of taking hormones, an annual reassessment is also required, including the adjustment of hormone concentration and dosage. In this way, "to eat or not to eat is no longer such a difficult question."
Menopause is not equal to HRT Menopause is not a disease, it is a phenomenon of natural aging and a process of continuous change. If you can have this level of understanding, you will understand that you don't have to rely on drugs to get through. "If you don't have menopausal symptoms, you don't need to take hormones" is the latest appeal in China and the West. The company of family members and a correct lifestyle can also relieve symptoms.
Dr. Guberta, a CNN professional medical writer, suggested that the best way to prevent menopausal symptoms is to develop good habits before menopause: eat right, drink plenty of milk, have enough exercise, and check cholesterol and blood pressure regularly .
Women who are in menopause should not be afraid of overwhelming information, discuss closely with doctors, and make the best choice for their own situation, so that they can get through this special stage of life safely.
Comment
Gentlemen, please read the previous report. Have you ever mentioned the arguments of Chinese medicine and how Chinese women have dealt with menopausal problems for more than 5,000 years? It’s just a partial bias towards Western medicine, ignoring the existence of Chinese medicine. I spend a lot of time telling patients that women’s menopause The problem is not a disease, it is a problem that every woman will encounter, it is the heart that is in charge of this period, any alternative therapy is tantamount to replacing the heart to do things, causing heart disease is to be expected, the severity is more than that, In addition to breast cancer, it is also easy to cause serious consequences such as lymphatic cancer, blood cancer, lung cancer, brain tumor and liver cancer. I believe that in a research report published by the National Institutes of Health on July 17 in the Journal of the American Medical Association (JAMA) I didn't list all the sequelae one by one to avoid causing women all over the country to sue doctors and pharmaceutical companies, because it will inevitably cause more panic than the 911 incident.
