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CNN Live Today

'Daily Dose'

Aired November 25, 2003 - 11:34   ET

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


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


HEIDI COLLINS, CNN ANCHOR: Federal health officials are considering whether to make an emergency contraceptive available over the counter. The so-called morning after pill contains the same hormones found in regular birth control pills, but the FDA is concerned about whether women will understand how to take them without a doctor's advice. Supporters say over the counter sales will give women better access to the pills in time to prevent pregnancy.
Well, is hormone replacement therapy making a comeback now? There are new types available. In today's "Daily Dose," I want to talk about that with CNN's medical correspondent Elizabeth Cohen.

She's joining us to talk about whether or not these options are actually better. And you know, I am convinced that people are thoroughly confused over this whole issue at this point.

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: They are thoroughly confused, so we're going try to unconfuse people and do a little hormone replacement therapy 101. Who can forget a year and a half ago when the big study came out that said hormone replacement therapy, the kind you take in the pill form, was linked to breast cancer, and to heart disease and to blood clots? And that sent thousands of women fleeing to their doctors and abandoning their hormone replacement therapy.

Well, since then, there are now two new forms that are out that may be different and some doctors say maybe people should try them. One is a ring that is a vaginal insert, and the other one is a patch that is placed on the body. Let's go through exactly how they work, and then later, we'll discuss whether they're safer than the kind that's already out there. The ring contains just estrogen, and it fights hot flashes and night sweats, and other menopausal symptoms, and it has to be replaced every three months.

The patch contains estrogen and progestin, which is a combination of hormones, also fights hot flashes and night sweats, and also osteoporosis, another benefit, and needs to be replaced once a week. Now because it's a patch and because it's a ring, it actually contains lower doses than the pill form, and that has some doctors saying that maybe perhaps it is a little bit safer.

COLLINS: Safer, great. Is it better?

COHEN: Again, this depends on who you ask, and this is where the confusion comes in. Some doctors are big advocates of these. Some doctors say, you know what, maybe a bit safer than the pill form, but still has some potential problems. Let's take a look at what those potential problems are. A potential problem with the ring is that it increases the risk of breast cancer, uterine cancer, heart disease and stroke.

Potential problems with the patch is that they could increase the risk of breast cancer and endometrial cancer, but actually it's a lower risk than the pill form for blood clots, because when you wear the patch, it doesn't go through the liver, and so it doesn't cause the same blood clot problems that the pill source could confirm.

So basically, what women have to do is talk to their doctors. If their menopausal symptoms are overwhelming, if they're ruining their life, they may want to seek one of these forms, and they may decide with their doctor that one of these forms is better than the pill form for them.

COLLINS: Are there other non-drug options out there as well?

COHEN: There are. There are some women that even though their symptoms are terrible, they don't want to take the drug. They've heard about that study, they don't want to get anything that is remotely like a drug. So let's go over some of the options that women can do.

First of all, there have been studies that show that deep breathing, kind of a yoga-style breathing and other stress reduction techniques can really help with hot flashes and other menopausal symptoms. Also, if you exercise and if you don't smoke, that helps enormously. Some studies have shown that eating foods rich in soy or taking a soy supplement and taking certain herbs can help. Other studies have shown that it doesn't. It really is up to each woman to decide if she wants to try those or not.

Also anti-depressants have worked for many women interesting enough, even if they're not necessarily clinically depressed. Antidepressants have been used successfully by some women. Those are drugs, but a different type of drugs than the hormone replacement therapy.

COLLINS: So obviously, the biggest thing is to talk with your doctor, again, about all of this, all of your concerns.

COHEN: Talk with your doctor and know, understand what the risks are. And once you know what the risks, you decide whether you want to take the risks. If you're menopausal -- not you personally. You're not at that age yet.

COLLINS: Not quite.

COHEN: But if your menopausal symptoms are that bad, you may decide you want to take those risks.

COLLINS: Elizabeth Cohen, thanks much. Good information to consider.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com





Aired November 25, 2003 - 11:34   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
HEIDI COLLINS, CNN ANCHOR: Federal health officials are considering whether to make an emergency contraceptive available over the counter. The so-called morning after pill contains the same hormones found in regular birth control pills, but the FDA is concerned about whether women will understand how to take them without a doctor's advice. Supporters say over the counter sales will give women better access to the pills in time to prevent pregnancy.
Well, is hormone replacement therapy making a comeback now? There are new types available. In today's "Daily Dose," I want to talk about that with CNN's medical correspondent Elizabeth Cohen.

She's joining us to talk about whether or not these options are actually better. And you know, I am convinced that people are thoroughly confused over this whole issue at this point.

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: They are thoroughly confused, so we're going try to unconfuse people and do a little hormone replacement therapy 101. Who can forget a year and a half ago when the big study came out that said hormone replacement therapy, the kind you take in the pill form, was linked to breast cancer, and to heart disease and to blood clots? And that sent thousands of women fleeing to their doctors and abandoning their hormone replacement therapy.

Well, since then, there are now two new forms that are out that may be different and some doctors say maybe people should try them. One is a ring that is a vaginal insert, and the other one is a patch that is placed on the body. Let's go through exactly how they work, and then later, we'll discuss whether they're safer than the kind that's already out there. The ring contains just estrogen, and it fights hot flashes and night sweats, and other menopausal symptoms, and it has to be replaced every three months.

The patch contains estrogen and progestin, which is a combination of hormones, also fights hot flashes and night sweats, and also osteoporosis, another benefit, and needs to be replaced once a week. Now because it's a patch and because it's a ring, it actually contains lower doses than the pill form, and that has some doctors saying that maybe perhaps it is a little bit safer.

COLLINS: Safer, great. Is it better?

COHEN: Again, this depends on who you ask, and this is where the confusion comes in. Some doctors are big advocates of these. Some doctors say, you know what, maybe a bit safer than the pill form, but still has some potential problems. Let's take a look at what those potential problems are. A potential problem with the ring is that it increases the risk of breast cancer, uterine cancer, heart disease and stroke.

Potential problems with the patch is that they could increase the risk of breast cancer and endometrial cancer, but actually it's a lower risk than the pill form for blood clots, because when you wear the patch, it doesn't go through the liver, and so it doesn't cause the same blood clot problems that the pill source could confirm.

So basically, what women have to do is talk to their doctors. If their menopausal symptoms are overwhelming, if they're ruining their life, they may want to seek one of these forms, and they may decide with their doctor that one of these forms is better than the pill form for them.

COLLINS: Are there other non-drug options out there as well?

COHEN: There are. There are some women that even though their symptoms are terrible, they don't want to take the drug. They've heard about that study, they don't want to get anything that is remotely like a drug. So let's go over some of the options that women can do.

First of all, there have been studies that show that deep breathing, kind of a yoga-style breathing and other stress reduction techniques can really help with hot flashes and other menopausal symptoms. Also, if you exercise and if you don't smoke, that helps enormously. Some studies have shown that eating foods rich in soy or taking a soy supplement and taking certain herbs can help. Other studies have shown that it doesn't. It really is up to each woman to decide if she wants to try those or not.

Also anti-depressants have worked for many women interesting enough, even if they're not necessarily clinically depressed. Antidepressants have been used successfully by some women. Those are drugs, but a different type of drugs than the hormone replacement therapy.

COLLINS: So obviously, the biggest thing is to talk with your doctor, again, about all of this, all of your concerns.

COHEN: Talk with your doctor and know, understand what the risks are. And once you know what the risks, you decide whether you want to take the risks. If you're menopausal -- not you personally. You're not at that age yet.

COLLINS: Not quite.

COHEN: But if your menopausal symptoms are that bad, you may decide you want to take those risks.

COLLINS: Elizabeth Cohen, thanks much. Good information to consider.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com