Women had been told for decades that estrogen taken with progestin would not only ease hot flashes and insomnia but help preserve bone strength,mental acuity and,most important,heart health. There's no question that HRT can ease the acute symptoms of menopause,and the claim about bone strength had held up to scrutiny. But after observing more than 16,000 women for roughly five years,researchers found conclusively that hormones raise the risk of heart attack,stroke,blood clots and breast cancer.
几十年来,女性一直被告知雌激素结合孕激素服用,不仅能缓解更年期阵发性发热感、失眠症,而且能帮助保持骨骼强度、心智锐敏,而最重要的是--有益心脏健康。毫无疑问,荷尔蒙替代疗法能缓解急性绝经期综合症,而且关于增强骨骼强度的说法也经住了考验。但是研究人员在对16000余名妇女进行了约5年之久的观察后发现,激素确实增加患心脏病、中风、血栓和乳腺癌的风险。
The announcement caused a near panic among the more than 13 million American women now on hormone-replacement therapy. Fortunately,the study didn't uncover huge,unimagined dangers to patients. But for millions of women juggling the pros and cons of long-term HRT,the new findings offer something virtually unprecedented,which is clarity. Even a small risk to individuals can have big consequences when applied to a large population.
The study suggests that,on balance,a group of 10,000 long-term estrogen users would suffer 31 excess health crises each year(strokes,heart attacks,blood clots,breast cancers),while avoiding only 11 bone fractures and colon cancers. That's a net increase of20. If 100,000 people take up long-term HRT,they'll suffer 200 of these needless events each year. A million long-term estrogen users will experience 20,000 of them annually--which means20,000 over the course of a decade. This is no way to prevent hip fractures.
这项声明在1300万目前正在接受荷尔蒙替代疗法的美国女性中几乎引起了恐慌。所幸的是,研究并未发现这种药对病人会有大到不可想象的危险。但是,对于几百万不确定是赞成还是反对长期荷尔蒙替代疗法的妇女来说,新发现确实是首次将问题明朗化。即便对个体来说危险很小,但倘若在人群中广泛应用,也会造成严重后果。
研究结果表明,总的来说,一组1万名激素长期服用者每年会额外地受到31次疾病的困扰(中风、心脏病、血栓、乳腺癌),而仅仅能避免11次骨折和结肠癌。这样患病次数就净增了20次。如果10万人接受荷尔蒙替代疗法,他们每年便会受到200次不必要的痛苦。100万激素长期服用者每年便会多受2000次苦--这意味着10年要多受2万多次苦。这可不是防止髋骨骨折的好办法。
Short-term use is a different story. The study didn't turn up unacceptable risks among womentreated for less than five years,and experts agree there is still no better treatment for the hot flashes,mood swings and insomnia that many women experience around the time of menopause.
短期服用则是另一回事。对治疗时间少于5年的妇女的研究并未发现不可接受的风险。而且专家也承认目前还没有更好的办法治疗许多妇女绝经前后的阵发性发热感、情绪波动和失眠症。