Washington About a quarter of women who stop taking hormone replacement therapy because of its risks wind up resuming the pills because of menopause misery, says the first research to explore how easy it is to quit.
Desperate for alternatives to alleviate hot flashes, more women are turning to certain antidepressants, such as Prozac and Effexor, that offer some relief even if users aren't depressed.
"They're very hot right now," said Dr. Nanette Santoro of the Albert Einstein College of Medicine. "Certainly in my clinical experience, they're the best second alternative" to estrogen.
Very few other options are backed by scientific evidence that they relieve what's considered menopause's worst symptom, hot flashes. Indeed, very few of the women who returned to hormone therapy had even tried an alternative, notes Dr. Deborah Grady of the University of California, San Francisco, who led the study about ease of quitting.
"One question that's important in my mind right now is how can we help these women?" Grady said.
It's a dilemma not just for women who suffer serious hot flashes for a few months surrounding menopause -- but especially for the 15 percent of women who keep having them for years.
Hormone therapy was long thought to protect postmenopausal women from such age-related conditions as heart disease and Alzheimer's. But sales have plummeted since July 2002, when a major study found hormone therapy in fact slightly raised users' risks of heart attack, stroke and breast cancer. That study examined combinations of estrogen and progestin; whether estrogen alone, used only by women who've had a hysterectomy, is as risky remains under study.