By CRISTY SHAUCK
Until recently, most health studies were performed exclusively on men. The medical community assumed that what was good for men would also benefit women. Although no long-term studies have been performed on women to verify such a claim, doctors have been treating women for diseases the same way as men--with the exception of hormone replacement therapy (HRT).
Ask a group of women what they know about HRT, and each will probably tell a different story. Depending on whether it was in fashion when she began menopause (the time when her doctor would discuss HRT) and her health history, a woman would be told she should or shouldn't take estrogen.
In 1993, the National Institutes of Health began recruiting women for the Women's Health Initiative, a nine-year study that may yield some clear answers about the effects of HRT and diet on heart disease and bone fractures in women.
"We are not convinced that all women in this country need to be on hormones, or we would not be doing this study," said Marcia Stefanick, Ph.D., principal investigator for the Stanford WHI site. "It's much less clear to us that the benefits outweigh the risks."
Coronary heart disease is the No. 1 cause of death in women. "We think of it as a man's disease, but just as many women die of it as men. The difference is we're about 10 years older. Women start getting heart attacks at about age 65, right when they start retiring, and so they are out of the public eye."
Stefanick said the current hypothesis is that HRT will prevent heart disease in women.
"It's very important for women to understand that we do not have proof that hormones are going to prevent heart disease," she said. "That's what the study is going to find out--whether this is a good strategy for women."
Sylvia Drew, Evelyn Gilberg and Millie Smith are among the 200 Sunnyvale residents participating in the study.
Drew, 72, began the hormone study nine months ago.
"I had a hysteretomy at 21," she said. "I had cysts and didn't receive hormones. No doctor has discussed it with me, but I decided to take a chance. Whether I'm on estrogen or the placebo, my mind tells me it's the hormone."
Anyone considering joining the study should "go for it. What can they lose? They have so much to gain and will help women in the future," Drew said.
Gilberg, 59, found out about the study when someone brought pamphlets to work.
As a member of the diet-change group, Gilberg will eat according to certain specifications, even when dining out.
"The hardest part will be finding the right foods on vacation," she said.
Smith, 70, hopes involvement in the study will help her make a lifestyle change.
"I know I should eat more veggies," she said.
Although she finds it difficult to keep track of what she eats three days a week, Smith said, "if it helps my daughters-in-law down the road, then I want to do it."
According to Stefanick, the Stanford WHI needs 2,000 more volunteers, age 54 to 79.
Volunteers for the HRT study must have stopped taking hormones for three months prior to joining the study. If they have breast cancer, they cannot participate. Women must have had a mammogram within the last 10 months in order to be accepted.
Volunteers for the diet study should be eating a typical American diet.
The diet study focuses on breast and colo-rectal cancer. Volunteers fill out a diet questionnaire when they come for the study orientation.
Those who aren't selected for the HRT or diet-change group can still provide valuable input.
"We have to have a group that doesn't change their diet so that we can have something to compare the diet change to," Stefanick said. "So you have to be willing to take either assignment the computer makes, based on nothing other than the fact that you are interested and eligible for the study."
The diet-change group must attend classes that are spaced farther apart as time goes by. The control group checks in annually.
There are currently 40 million postmenopausal women in the U.S. By the end of the study, there will be 50 million. Stefanick is eager to provide these women with study results that will allow them to make informed decisions about health.
"Women have to realize how important the study is," she said. "If we don't get enough women in the study, we all lose because we don't get the information we need. To finally get a study funded, and then not get enough women come in to it would be a real shame."
The Stanford Women's Health Initiative is located at 2680 N. First Street in San Jose. For more information or to volunteer for the study, call 944-9444..
This article appeared in the Sunnyvale Sun, February 26, 1997.
©1997 Metro Publishing, Inc. All rights reserved.