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Sarah Bates Independent-Mall
Pam Trble, pharmac manager at Aed Pharmac
and Medical Eqipment on Greenvlle Street, holds a
vrety of diferent forms of estrogen. News that estro­
gen ad another hormone, progestin, may have danger­
ous side effects has caused concern among women who
take them to relieve the effecs of menopause.
Local medica professionals encourage
consultation for hormone therapy
By Kelly Davs
Independent· Mall
Women taking replacement
hormones should consult with
their physicians before quittig
the therapy out of fear they are at
icreased risk of breast cancer,
stroke or heart attack. local
physicians and pharmacists say
" Wat we have ended up rec,
ommendig is. one answer does­
n' t ft everybody" said Dr Matt
Cl ine, a family physic i an and
coordiator of obstetrics and
gynecology for the AnMed
Famiy Practice Residency pro­
At issue i s t he use of estrogen
and progesti hormones for post­
menopausal women. Doctors
have prescribed the hormones for
years to reduce the effects of
Please see Exers. Page 4A
From Page l A
menopause. especially hot flashes. isom­
ni a, vaginal dryness and fatigue. The hor­
mones have also been thought to reduce
the risk of heart disease, bone thining
and some cancers.
But two studies investigating these hor­
mones' benefits may have unearthed
unacceptable side effects. including more
frequent breast cancer, heart attacks and
The increased risk remains smal. and
Dr. Cline said women should talk to a doc­
tor before abandoning their regies cold
One study showed that taking estrogen
and progestin over long periods aoes noth­
ing to reduce the risk of heart attacks in
older women who already have heart dis­
The second study the Women's Health
Initiative of the National Institutes of
Health, was designed to see i the same
combination of hormones reduced the
risk of heart disease in younger women,
between 50 and 79 years old, who do not
have heart disease.
That study was supposed to follow
16,608 women for eight years but made
headlines this month when it was stopped
after an average of just more [han five
years of follol\' -up because [00 many par­
ticipants - eight in 10. 000 - deve!oped
breast cancer.
The drama of a maj or study being
stopped in irs tracks has caused some
panic. bm medical experts are urging
women taking the hormones not to be
alarmed but to schedule a talk vvith their
health care provider to reevauate their
"I've seen some people just quit taking
it, " said Anderson pharmacist Kevin
Bryant of Bryant Pharmacy
About a dozen people have called the
pharmacy to cancel prescriptions or ask
for advice, he said.
"Doctor's don't reveal to us all the cus­
tomers' diagnoses, so we don't know all
the reasons they're taking it, " he said. "So·
I'm not able to tell them one way or the
He does tell his customers they should
check with their doctor but need not stop
therapy right away
Dozens of patients of the AnMed
Family Practice Center have called since
the news broke, Dr. Cline said.
But "i they're on diferent therapy
than what was in the study these results
don't necessarily apply" he said.
For example, the studies di d not
address whether smaller hormone doses
may change the amount of added risk.
Also unknown is whether estrogen,
progestin or the combination are respon­
sible for the increased risks. Patients
whose uteruses have been removed don' t
take progestin and therefore may not be
affected. Dr. Cline said.
" It depends on what the hormone
replacement therapy was being used to
do, " he said. "If it was for heart disease
reduction, it's not a valid use. I it's for
osteoporosis, it's still a valid use, but you
have to balance it against the risks. "
Menopausal symptoms, which occur in
American women at the average age of 51,
can be extremely uncomfortable and hor­
mone replacement therapy is effective for
those symptoms.
Dr. Cline predicted that it would contin­
ue to be used for menopause relief but the
duration of treatment may shorten to
months instead of years.
"Seriously if I'd had a menopausal
patient in front of me si months ago, I
would have said, 'Yes, you will most likely
be on hormone replacement therapy for a
decade or more' , " he said. "I doubt I would
say that ever again. Those (other benefits)
have all been shot down."

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