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Hormone use is complex, especially for women

Dr. Lori A. Wroble, ob-gyn chief at MIT Medical, says hormone replacement therapy helps most women in the first five years of menopause.
Dr. Lori A. Wroble, ob-gyn chief at MIT Medical, says hormone replacement therapy helps most women in the first five years of menopause.
Photo / Donna Coveney

Hormones have been touted to improve everything from your sex life to your memory, but hormone replacement therapy is complicated, and more so for women than for men, said panelists at the 16th annual Catherine N. Stratton Aging Successfully Lecture.

The April 8 lecture, "Hormones and the Hands of Time," sponsored by the MIT Women's League and MIT Medical, was held in Wong Auditorium.

In addition to estrogen and testosterone, there is growth hormone and dehydroepiandrosterone, or DHEA, a steroid hormone that athletes use to enhance their performance, among them home run king Mark McGwire.

Hormones are chemical messengers, present in tiny but potent amounts in our bodies. They control growth and development, help us respond to stress, maintain our blood sugar and allow preprogrammed genetic information to unfold. While growth hormone has been helpful for those with deficiencies, there is no evidence that supplemental growth hormone or DHEA has any health benefit and may have significant risks, panelists said.

"There is not a one-size-fits-all recommendation for the male or the female," said Dr. William M. Kettyle, director of MIT Medical and moderator of the lecture.

At around age 50, when women's bodies no longer produce estrogen, they enter menopause. Some men may experience a far less dramatic change, a small drop in testosterone dubbed andropause. The question for many aging Americans is whether to take supplemental hormones.

In light of results from the hormone program of the Women's Health Initiative, a study following more than 16,000 postmenopausal women taking either estrogen plus progestin or a placebo, some women have halted hormone replacement therapy and men have shied away from testosterone treatments for symptoms such as decreased sex drive and sexual function. The study linked hormone use to higher risks of ovarian and breast cancer but lower risks of colon cancer.

In spite of alarms raised by some clinicians regarding testosterone treatment, panelist Abraham Morgenthaler, director of Men's Health Boston and associate professor of surgery at Harvard Medical School, said he thinks testosterone use is safe and can dramatically improve symptoms for some men. He said studies have shown no connection between testosterone treatment and heart disease or prostate cancer in men.

Likewise, estrogen can alleviate hot flashes, loss of sex drive and vaginal dryness in menopausal women, said Dr. Lori A. Wroble, chief of the obstetrics and gynecology service at MIT Medical. It also can help prevent osteoporosis and heart disease.

"I am a firm believer that hormone replacement therapy is a good thing for most women in the first five years" from the onset of menopausal symptoms, said Dr. Wroble. After that, she said, women need to consider their own risk factors in an in-depth meeting with their doctor.

A version of this article appeared in MIT Tech Talk on April 16, 2003.

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