Last week I was surprised to discover that the October 27, 2002, New York Times included a story in their Health section that the National Institutes of Health (NIH) had a meeting to discuss the confusion wrought by the media report about The Women's Health Initiative study. (The study showed that if 10,000 post-menopausal women take a combination of estrogen and progesterone: eight more than those on estrogen only or no hormone therapy will develop invasive breast cancer, have a stroke or a blood clot in their lungs, and seven more will have a heart attack. It also showed the drug combination decreases hip fractures and colo-rectal cancer.)

According to the reporter, instead of ERT for estrogen replacement therapy or HRT for hormone replacement therapy, future language should reflect the more accurate term, menopause hormone therapy (MHT). This meant a major change for medical personnel, health educators, researchers, etc. in the language used to discuss an issue of importance to every post-menopausal woman.

I immediately went to the NIH web site to read more about this decision. I couldn't find any notice, press release or commentary that reflected the info in the Times article. There was a notice for the meeting cited in the article. Perhaps, I thought, the webmaster had not posted the information. I called the NIH. They had no knowledge of any such decision. I called a physician I knew who attended the meeting. She also was "in the dark" regarding my query.

I was told that discussion at the meeting centered on the use of the word "replacement" in the commonly used terms estrogen replacement therapy or hormone replacement therapy. The consensus was that using "replacement" infers that the drugs would return women's hormone status to pre-menopausal levels (and keep them young). In fact they are recommended solely to reduce menopausal symptoms (hot flashes, incontinence, loss of libido, etc.) or to prevent osteoporosis (despite the availability of other drugs that may be more suitable). Additionally the doctors were eager to affirm that menopause is a natural progression of life for women; a close to that period of life when she is of child-bearing age-reversing the process that began at puberty when her menstrual cycle and child-bearing age began.

Although this discussion about removing the word "replacement" from literature and when doctors talked about this treatment, no official recommendation was made or policy officially changed. NIH personnel did not know the source of the NY Times author's story.

It is possible that in the future there will be more "official" recommendations for use of the terminology to describe hormone treatment. However, the use of the ERT or HRT terminology is so pervasive [that] it's not likely to happen soon.

In the meantime, take the message to heart. Estrogen (for women who don't have a uterus) -- or estrogen and progesterone (added to estrogen to prevent endometriosis in women who have a uterus) - are only two of several treatment options available to enhance the quality of life for post-menopausal women. It does not make them young again. Neither of these "therapies" can (accurately) "replace" the hormones whose output decreases significantly at menopause. The best any woman can do is discuss her options with her physician and make an informed choice about how to best handle the issues that come with a natural phenomena called "aging."

Once again, my mantra: Regular exercise and a healthy diet are a valuable adjunct to keeping us feeling younger than our chronological years.