Women had been told for decades that estrogen taken with progestin would not only ease hot flashes and insomnia but help preserve bone strength，mental acuity and，most important，heart health. There's no question that HRT can ease the acute symptoms of menopause，and the claim about bone strength had held up to scrutiny. But after observing more than 16,000 women for roughly five years，researchers found conclusively that hormones raise the risk of heart attack，stroke，blood clots and breast cancer.

    幾十年來，女性一直被告知雌激素結(jié)合孕激素服用，不僅能緩解更年期陣發(fā)性發(fā)熱感、失眠癥，而且能幫助保持骨骼強(qiáng)度、心智銳敏，而最重要的是--有益心臟健康。毫無疑問，荷爾蒙替代療法能緩解急性絕經(jīng)期綜合癥，而且關(guān)于增強(qiáng)骨骼強(qiáng)度的說法也經(jīng)住了考驗。但是研究人員在對16000余名婦女進(jìn)行了約５年之久的觀察后發(fā)現(xiàn)，激素確實增加患心臟病、中風(fēng)、血栓和乳腺癌的風(fēng)險。
 
    The announcement caused a near panic among the more than 13 million American women now on hormone-replacement therapy. Fortunately，the study didn't uncover huge，unimagined dangers to patients. But for millions of women juggling the pros and cons of long-term HRT，the new findings offer something virtually unprecedented，which is clarity. Even a small risk to individuals can have big consequences when applied to a large population.

    The study suggests that，on balance，a group of 10,000 long-term estrogen users would suffer 31 excess health crises each year（strokes，heart attacks，blood clots，breast cancers），while avoiding only 11 bone fractures and colon cancers. That's a net increase of20. If 100,000 people take up long-term HRT，they'll suffer 200 of these needless events each year. A million long-term estrogen users will experience 20,000 of them annually--which means20,000 over the course of a decade. This is no way to prevent hip fractures.

    這項聲明在1300萬目前正在接受荷爾蒙替代療法的美國女性中幾乎引起了恐慌。所幸的是，研究并未發(fā)現(xiàn)這種藥對病人會有大到不可想象的危險。但是，對于幾百萬不確定是贊成還是反對長期荷爾蒙替代療法的婦女來說，新發(fā)現(xiàn)確實是首次將問題明朗化。即便對個體來說危險很小，但倘若在人群中廣泛應(yīng)用，也會造成嚴(yán)重后果。

    研究結(jié)果表明，總的來說，一組1萬名激素長期服用者每年會額外地受到31次疾病的困擾（中風(fēng)、心臟病、血栓、乳腺癌），而僅僅能避免11次骨折和結(jié)腸癌。這樣患病次數(shù)就凈增了20次。如果10萬人接受荷爾蒙替代療法，他們每年便會受到200次不必要的痛苦。100萬激素長期服用者每年便會多受2000次苦--這意味著10年要多受２萬多次苦。這可不是防止髖骨骨折的好辦法。
 
    Short-term use is a different story. The study didn't turn up unacceptable risks among womentreated for less than five years，and experts agree there is still no better treatment for the hot flashes，mood swings and insomnia that many women experience around the time of menopause.

    短期服用則是另一回事。對治療時間少于5年的婦女的研究并未發(fā)現(xiàn)不可接受的風(fēng)險。而且專家也承認(rèn)目前還沒有更好的辦法治療許多婦女絕經(jīng)前后的陣發(fā)性發(fā)熱感、情緒波動和失眠癥。