The Washington Post - 03.03.2020

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HEalth&Science

TUESDAy, MARCH 3 , 2020. WASHINGTONPOST.COM/HEALTH-SCIENCE ee E

Women and hormone therapy

Long shunned, the treatment is now seen as safe for easing m enopause symptoms

PESTS

rats like all sorts of human

food, which is a problem. E2

DISEASE

Monkeys in florida are

infected with herpes. E2

FOOD SAFETY

How to avoid getting sick

from leafy greens. E3

AGING BRAINS

the debate over cognitive

screening for seniors. E4

BY STEVEN PETROW

Having once been told I’m at very
high risk for a heart attack, I’m no fool
when it comes to cardiovascular dis-
ease. I read studies. I submit to blood-
work at least twice a year. I take my
meds and have changed my diet. I see
my cardiologist annually.
I also write about health, so I often
look at cardiovascular disease from a
less personal, more objective view.
still, I recently discovered while at-
tending a symposium featuring doz-
ens of the national top cardiologists
that there’s much I didn’t know about
heart disease — or realized my infor-
mation was outdated.
Here are some key points.
Don’t take low-dose aspirin if you
haven’t had a heart attack. For years,
doctors urged healthy older people to
take 81 milligrams of aspirin daily,
which studies had concluded would
help prevent a first heart attack. “That
thinking has changed recently,” said
Carl e. orringer, director of the Pre-
see HeArT on e6

PERSPECTIVE

New do’s and

don’ts about

heart disease

BY ABDUL-KAREEM AHMED

“I use a spoon instead o f a fork, s o I
spill less,” the patient said. “I eat
sandwiches and hamburgers so I can
use both hands to hold my food.”
He was 73 and had suffered from
essential tremor for the past decade.
His hands would shake uncontrolla-
bly, more on the right than on the
left, which would worsen if he tried
using them.
“I could still do crowns, but giving
injections became impossible,” he
said. His disease, gradual and grasp-
ing, had forced the Baltimore-area
dentist into early retirement.
The patient, who is not being
named to protect his privacy, was
going to undergo surgery to treat his
tremor, which I was curious to ob-
serve. I headed to the MRI exam suite
to meet him.
Wearing a hospital gown, he sat at
the edge of his bed, talking to the
attending neurosurgeon. He was tall,
and balder today than he usually
see Tremor on e5

MRI-guided

surgery fixed

his tremors

BY BEN OPIPARI

The day before Matthew simon
was to begin crew practice in 2015 as a
sophomore at Walt Whitman High
school in Bethesda, he was diagnosed
with leukemia.
simon was a rower who worked
out daily. His initial stay for treat-
ment at C hildren’s Hospital was three
weeks long, and the sedentary rou-
tine of chemotherapy was tough. “I
got stir crazy,” simon said. “Patients
in a pediatric oncology unit are im-
munocompromised, so we couldn’t
leave the floor. There’s n ot much to do
but walk around.”
He walked laps around the unit
when his strength permitted. But
walking isn’t rowing, so the staff
found an expresso Go virtual reality
bike and moved it into his room,
where he rode it daily. After this
initial round of treatment, simon
moved to Johns Hopkins, where he
sometimes spent several days at a
time as an inpatient. There was an
exercise bike there too, which he rode
often. It helped ward off some of the
see cANcer on e6

The 10-speed

cancer therapy:

Bike exercise

could make a menopausal woman whole again in the

eyes of men like Wilson, who apparently received

funding from Wyeth (the pharmaceutical maker of

the hormones he was promoting).

For a while, it seemed that hormones such as

estrogen might also protect against heart disease

and keep women’s minds healthy, too.

What was then called “hormone replacement

therapy” seemed so powerful that in 1993 research-

ers initiated the Women’s Health Initiative (WHI), a

randomized clinical trial of more than 10,000 wom-

en ages 50 to 79 to test whether taking estrogen,

either alone or with progesterone, continuously

after menopause could help women prevent heart

disease, stroke and cognitive decline.

In 2002, the WHI study released startling news —

women assigned to take the hormones had a higher

risk of cardiovascular disease and breast cancer than

see HormoNeS on e5

L

ook at the Internet ads and news headlines

about menopausal hormone therapy and

you’ll find two competing story lines: Ta k-

ing hormones is either going to keep a

woman young and solve all her meno-

pause-related woes, or it’s going to give her breast

cancer and other scary diseases.

The truth is that neither narrative is universally

correct. Although consensus now exists that women

shouldn’t take hormone therapy long term, hor-

mones can still safely help many women in the

throes of menopause

Fifty years ago, hormones were advertised as a

cure-all. In his 1966 bestseller, “Feminine Forever,”

physician Robert Wilson declared that menopause

was a disease, and he had the cure: hormones,

without which women would be “condemned to

witness the death of their own womanhood.”

The magic of hormone therapy wasn’t just that it

AnnA godeAssI for tHe WAsHIngton Post

BY CHRISTIE

ASCHWANDEN