Postmenopausal women have for decades relied on estrogen supplements to control the hot flashes, memory loss, osteoporosis and other ailments that can occur when their bodies no longer produce the compound. But hormone replacement therapy (HRT) is no longer considered the best way to treat menopause, ever since a report last year found that women receiving a certain type of HRT were at increased risk for dangerous side effects, such as breast cancer. Many health professionals have concluded that altering a woman's physiology will always increase risks over time. But a handful of respected scientists are calling for another look at HRT, arguing that not all therapies are created equal.

The largest blow to HRT appeared in the July 17, 2002, Journal of the American Medical Association. It presented important results of the Women's Health Initiative's long-term study of more than 16,000 women taking estrogen and a progesterone derivative. The study was halted prematurely, the authors reported, because too many women were encountering serious medical problems. "I believe that the drug we studied has more harms than benefits when used for the prevention of chronic diseases such as osteoporosis in generally healthy women," notes Jacques Rossouw, project officer of the initiative. In the past year a steady cascade of articles has enumerated all the higher risks that patients in the study experienced: an 81 percent increase in heart disease in the first year of therapy, a 24 percent increase in invasive breast cancer and a 31 percent increase in stroke. The therapy also doubled the risk of dementia. (A study of more than 800,000 women published in Lancet on August 9 also found an increased risk of breast cancer in postmenopausal women receiving a wide variety of HRT but noted that the risk of mortality from breast cancer related to HRT could not be determined.)

This article was originally published with the title Hormone Hysteria?.

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