Some Important Facts About the Hormone Study
By Cristin Babcock, MD
Some of my patients have expressed confusion about the results of the Women’s Health Initiative (WHI). The study was a major clinical trial of the risk and benefits of the combined estrogen/progestin drug Prempro. The study was stopped early because researchers found a slight increased risk of invasive breast cancer. The trial also found slight increases in the incidence of heart disease, stroke and blood clots.
The Fall 2002 issue of Healthy Perspectives discussed ramifications of the findings, and I won’t revisit those here. But here are some important points to remember about the WHI findings:
Because of the WHI, the pendulum has swung to discouraging hormone use for most women. Will it swing back again? The studies we want to see—randomized to start or not start hormones, conducted for 10 to 20 years—aren’t being done. In the absence of those studies, the picture is unclear. Please use your Women’s Care physician as a resource to help you weigh your personal risks, benefits and concerns related to menopause and hormone replacement therapy.
Some of my patients have expressed confusion about the results of the Women’s Health Initiative (WHI). The study was a major clinical trial of the risk and benefits of the combined estrogen/progestin drug Prempro. The study was stopped early because researchers found a slight increased risk of invasive breast cancer. The trial also found slight increases in the incidence of heart disease, stroke and blood clots.
The Fall 2002 issue of Healthy Perspectives discussed ramifications of the findings, and I won’t revisit those here. But here are some important points to remember about the WHI findings:
- The WHI showed a two fold reduction in hip fractures despite the short study period of five years. Bottom line: Estrogen replacement therapy is very effective for treating decreased bone density, either osteopenia or osteoporosis.
- The WHI excluded menopausal women under age 50. Women with menopausal symptoms were discouraged from participating. Ninety percent of the women in the study were over 60 years old. Of the women studied, 88 percent hadn’t been on hormones before the study began. Bottom line: WHI is really a study of asymptomatic women in their mid-60s studied for a relatively short time.
- WHI researchers plan to write 26 articles based on the study results. So far, four have been written and were summarized in news media. There are 22 articles yet to come, and those will surely be discussed in the news media, as well. Bottom line: Remember that the articles all pertain to the same study, and the findings may or may not relate to the average woman using hormones.
Because of the WHI, the pendulum has swung to discouraging hormone use for most women. Will it swing back again? The studies we want to see—randomized to start or not start hormones, conducted for 10 to 20 years—aren’t being done. In the absence of those studies, the picture is unclear. Please use your Women’s Care physician as a resource to help you weigh your personal risks, benefits and concerns related to menopause and hormone replacement therapy.
