Ask Dr. Marie

The results of the Women’s Health Initiative study in 2002 suggesting that the risks of hormones may outweigh the benefits had millions of women stopping their hormones overnight. And just as quickly, hot flashes returned, thermostat settings were lowered, and bedcovers were thrown off in homes everywhere.

Yet two recent segments on “The Oprah Winfrey Show” touting the benefits of hormones have women scrambling to get prescriptions again from their doctors. The hormones Oprah’s guests were applauding, called bio-identicals, are shelved under “natural” menopausal hormones and are often made to order and compounded at a pharmacy.

Two recent studies remind me that frequent and early screening mammograms may not always (emphasis on “not always”) be a good idea. The first study in JAMA looked at women who received chest radiation as a child and found that only about half of the women had a screening mammogram within the past two years – despite evidence that their exposure to radiation as a child may increase their risk of breast cancer. The article’s headline seemed to suggest that women with such a risky history were in some way negligent when in fact they (or their doctors) may have been appropriately cautious about doing too many x-rays. An accompanying editorial wisely suggested in my opinion that maybe women with childhood radiation should have less exposure to x-rays rather than more exposure. The editorial raised the question whether perhaps breast MRI’s would be a better way to screen high risk women with a history of childhood radiation to avoid unnecessary and potentially risky x-ray exposure.