HRT usage waned after damning 2002 report: study

Fewer Canadian women over the age of 65are using hormone replacement therapy (HRT), the likely result of a 2002 study that found the practice had more risks than benefits, says a new report.

Thereport, published by the Canadian Institute for Health Information and released Thursday, found that in the five provinces studied Alberta, Saskatchewan, Manitoba, New Brunswick and Nova Scotia use of HRT among women over 65 dropped from 14 per cent to five per centbetween the periods of2001-2002 and 2006-2007.

The average drop per year among HRT users was 17 per cent per year during the study period. In the first two years after the release of the 2002 Women's Health Initiative Study a sweeping report which found HRT posed serious risks, such as a higher risk of heart disease and stroke usage fell 30 per cent.

In terms of dosage,women taking a higher dose (0.625 mg) of estrogen in 2000-2001 and still taking HRT in 2006-2007, 37 per cent were taking a lower dose(0.3 mg), the report finds.

In 2006-2007, the rate of estrogen-only HRT use was 3.1 per cent to 5.4 per cent across the provinces, while use of combination HRTranged from 0.5 per cent to 1.1 per cent.

The report relies on data from the National Prescription Utilization Information System database, as well as population data from Statistics Canada.

"New evidence highlighting the potential risks of HRT, as well as its lack of benefit in preventing heart disease, has forced caregivers and patients to re-examine its use, particularly in elderly patients," said Dr. Jennifer Blake, the chief ofobstetrics and gynecology at Sunnybrook Health Sciences Centre in Toronto.

HRT, a combination of estrogen and progestin or estrogen alone, is used to relieve menopausal symptoms such as hot flashes, as well as offering protection against heart disease and bone loss brought on by waning hormone levels.

"Current Canadian guidelines recommend that both estrogen-only and combination HRT be taken at the lowest effective dose," said Blake.