Based on the Results of the Women's Health Initiative and Other Studies

The Women's Health Initiative (WHI) is a major 15-year research program to address the most common causes of death, disability and poor quality of life in postmenopausal women -- cardiovascular disease, cancer, and osteoporosis.

Taking into account all of the findings from WHI and other studies, here are bottom-line health recommendations for women:

• Heart Disease: Hormone therapy should not be used to prevent heart disease. In women with heart disease, it should not be used to prevent further disease because it increases the risk of blood clots.
  
  There are many things women can do to reduce their risk for heart disease.
  • Don't smoke, and if you do, quit. Women who smoke are two to six times more likely to suffer a heart attack than non-smoking women.
  • Aim for a healthy weight. It's important for a long, vigorous life. Overweight and obesity cause many preventable deaths.
  • Get moving. Make a commitment to be more physically active. Aim for 30 minutes of moderate-intensity activity on most, preferably all, days of the week.
  • Eat for heart health. Choose a diet that is low in saturated fat, trans fat, and cholesterol. Be sure to include whole grains, vegetables, and fruits.
  • Know your numbers. Ask your doctor to check your blood pressure, cholesterol (total, HDL, LDL, triglycerides), and blood glucose. Work with your doctor to improve any numbers that are not normal.
    
    
• Breast Cancer: Women should continue to take steps to reduce their risk of invasive breast cancer, such as having regular mammograms and breast examinations.
• Menopause Symptoms: Hormone therapy products are effective for treating moderate-to-severe hot flashes and night sweats, and vaginal dryness associated with menopause, but carry serious risks, especially in older women. Women who use or are considering using estrogen or estrogen with progestin treatments should discuss with their health care providers whether the benefits outweigh the risks. From the results of the two WHI clinical trials of hormone therapy, estrogen alone and estrogen with progestin, the Food and Drug Administration concluded that hormone therapy should be used only at the lowest doses for the shortest duration to reach treatment goals. It is not known at what doses there may be less risk of serious side effects.
  
  
• Protecting Against Bone Loss and Preventing Fracture: If hormone therapy is used for prevention of bone loss or osteoporosis, the risks for osteoporosis must outweigh the risk of the therapy. Women considering taking hormone therapy for osteoporosis should ask their health care providers about other medications that are considered safe and effective for preventing osteoporosis and bone fractures. To guard against bone loss or fractures, it is recommended that women should take at least 1000-1500 mg of calcium and 400-800 IU of vitamin D daily.
  
  
• Colorectal Cancer: People should talk with their health care provider about when to begin screening for colorectal cancer, what tests to have, the benefits and risks of each test, and how often to schedule appointments. Colorectal cancer screening programs should begin by classifying an individual's level of risk based on a number of factors. Tests to consider include colonoscopy, sigmoidoscopy, fecal occult blood tests, digital rectal exam, and double barium contrast enema. Individuals who are at increased risk for colorectal cancers may need to follow a different screening schedule, such as starting at an earlier age or being screened more often. The decision to have a certain test will take into account several factors including a person's age, medical and family history, and general health as well as accuracy, preparation, and risks of the various procedures.
  
  
• Cognition and Memory: Menopausal hormone therapy is not recommended for the prevention of cognitive disorders such as Alzheimer's disease or memory loss. In fact, WHI found that women treated with hormone therapy have a greater risk of developing dementia.

For more information about WHI, please visit www.nhlbi.nih.gov/whi.

February 2006