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CNN AMERICAN MORNING WITH PAULA ZAHN

Drug Dilemma

Aired March 14, 2003 - 08:43   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

PAULA ZAHN, CNN ANCHOR: We have heard that the risks associated with hormone replacement drugs, like Primpro, outweigh the benefits. Well, now, the FDA has approved a low dose version of Primpro. What does it mean for women taking hormone replacement therapy?
Dr. Susan Love has written the book on hormones and menopause. She joins us from Los Angeles.

Good morning, Dr. Love.

What does this latest study mean?

DR. SUSAN LOVE, "DR. SUSAN LOVE'S HORMONE & MENOPAUSE BOOK": It's not a study. What the FDA has done is approved a lower dose of Primpro than what was available earlier. And everybody hopes by lowering the doses, the risks will be less, and we need to do some studies to find out if that's true.

ZAHN: So you're not so convinced this is the right way to go?

LOVE: No. I think it's probably safer if you're taking hormones short term to get over the hump of symptoms to take a lower dose than a higher dose. You know, it sort of reminds of the birth control pills that we took, or I took when I was young, they were industrial strength compared to what we're taking now. Well, the dose of premarin that we were using is also much higher than probably as necessary. So the hope is by getting to a much lower dose, we may be able to do better.

ZAHN: But what are the risks still associated, you think, with even the lower dosages of Primpro?

LOVE: Well, the short-term use for symptoms are fine, but long term, for prevention, increases heart attacks, increases strokes, increases breast cancer, blood clots, gall bladder disease. There are some benefits. It does decrease fractures and colon cancer, but actually the risks far outweigh those benefits, and we have other drugs that work just as well.

ZAHN: We're going to come back to that in a moment. But I wanted to put up on the screen some of the risks that have been associated with hormone replacement therapy -- breast cancer, heart disease, stroke, blood clots. The National Institutes of Health reported last spring that millions of women were at risk of these potential, if they were on this particular kind of drug.

Now, a lot of women when they heard this news got off of the hormone replacement therapy altogether. Was that the way to go?

LOVE: Well, if you stop cold turkey, a lot of women will have symptoms. They'll get hot flashes again, they'll not be able to sleep and feel miserable.

And I think the message that didn't get out there is that if you stop gradually over six to nine months, you'll feel a lot better. So the women that stopped cold turkey felt terrible and went back on need to re-evaluate and say, OK, I'm going to take a long time to get off, but they really need to get off, that there is no group that taking long-term hormone replacement therapy is worthwhile. It's risky for everybody.

ZAHN: What do you tell your patients who don't want to use drugs at all? Are there any alternatives that you have found to be effective?

LOVE: Well, we don't have to do anything. You know? it really is normal and natural to go through menopause, and about a third of women have no symptoms. But for those women who are suffering, there are things. Black cohash is quite good. It's not estrogenic, and it's been well studied in Germany, and there's some studies here in this country as well. Exercise helps a lot. Acupuncture is good for hot flashes. Even increasing the amount of soy in your diet as food, not as supplements, but eating more soybeans and tofu. All of those things can help. And the good news is the symptoms of menopause are really transient. It's puberty in reverse. And not fun, but like puberty, doesn't last forever.

ZAHN: Dr. Susan Love, the author of "Dr. Susan Love's Hormone and Menopause Book," thanks for getting up at the crack of dawn for us this morning.

LOVE: Always a pleasure, Paula.

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