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One surprising twist in the results: The younger estrogen-takers actually had a lower risk for heart problems, breast cancer and death than those taking dummy pills. Researchers don't know why and say women should not use that as a reason to take hormones. They hope answers may be found in further research.
The results suggest that for every 10,000 women in their 50s taking estrogen for a year, there would be 12 fewer heart attacks and 13 fewer deaths than among women not on estrogen, said Dr. JoAnn Manson, a study co-author and chief of preventive medicine at Harvard's Brigham and Women's Hospital.
However, using the same comparison for women in their 70s, there would be 16 extra heart attacks and 19 extra deaths for those on estrogen versus those not taking the pills, she said.
"It's really powerful and compelling evidence," Manson said.
Breast cancer also appeared to be less common in women who'd taken estrogen than among those on dummy pills. An editorial accompanying the study notes that those findings contrast with many studies linking estrogen pills with an increased breast cancer risk.
Andrea LaCroix, the study's lead author and a researcher at the Fred Hutchinson Cancer Research Center in Seattle, said it's possible that estrogen didn't have a harmful effect on breast tissue in women studied because they were taken well after menopause when women's naturally occurring estrogen levels have declined.
Dr. Graham Colditz, a Washington University researcher who co-wrote the editorial, noted that duration of estrogen use as directed was pretty short during the study, averaging about 3 1/2 years, and most women started taking the hormone years after a hysterectomy or after menstrual periods ended.
"The results really don't directly translate to how we see women getting hormone therapy in the real world of current American medicine," Colditz said.
Women's Health Initiative:
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