Estrogen risk

WASHINGTON -- Government scientists abruptly ended the nation's biggest study of a type of hormone replacement therapy, saying long-term use of estrogen and progestin significantly increased the women's risk of breast cancer, strokes and heart attacks.

Six million American women use this hormone combination, either for short-term relief of hot flashes and other menopausal symptoms or because of doctors' longstanding assumptions that long-term use would prevent heart disease and brittle bones and generally keep women healthier longer.

Two of those assumptions are wrong, the National Institutes of Health announced Tuesday. In fact, yearslong use of estrogen and progestin increased otherwise healthy women's risk of a stroke by 41 percent, a heart attack by 29 percent and breast cancer by 24 percent.

On the good side, it cut by a third the risk of colon cancer and hip fractures -- but there are other ways to fend off those illnesses, doctors noted.

Concluding the hormones' risks outweighed those benefits, the NIH stopped the 16,600-woman study three years early -- and is advising other women who use the estrogen-progestin combination to ask their doctors if they, too, should quit.

If you're using it for heart disease, "forget about it," said Dr. Jacques Rossouw, acting director of the NIH's Women's Health Initiative, which sponsored the study. "For osteoporosis, in some women there may be a place. For promoting overall health, our data suggests it's not a good idea."

Other researchers were more negative.

"We recommend that clinicians stop prescribing this combination for long-term use," wrote Dr. Suzanne Fletcher of Harvard Medical School in an editorial accompanying the study results posted on the Web site of the Journal of the American Medical Association. "Risks from the drug add up over time."