The results are unlikely to settle the question. Early Menopausal Women May Benefit Dr. Sidney Smith of the University of North Carolina, a spokesman for the American Heart Association, noted that neither HERS nor the latest study shows whether hormone replacement helps if begun early in menopause or before women develop heart disease. The answer to those questions should come from the federally sponsored Women's Health Initiative, which is examining the effects of hormone replacement on more than 27,000 women ages 50 to 79. The first results are expected in about five years. Weighing the risks and benefits of estrogen is already complex.
Many women use it for a few years to relieve hot flashes and other ill effects of menopause.
Others stay on the hormone for many years to improve cholesterol levels and to prevent brittle bones and vaginal changes, even though the treatment can also increase the risk of breast cancer. Now doctors are clearly confused and divided over what to expect from estrogen on the heart. However, many agree that even if the hormone proves to be good, its benefit is unlikely to be as large as that of statin drugs, which clearly lower cholesterol and save lives. After four years, doctors measured their heart arteries and found no difference in the progression of their disease. Dr. Marion Limacher of the University of Florida said that until recently, she routinely recommended estrogen supplements for older women with heart disease.