Hormone replacement therapy

doi:10.1136/bmjusa.02090003

BMJ, doi: 10.1136/bmjusa.02090003, (Published 27 November 2002)

Editorials

Hormone replacement therapy

What shall we tell our patients now?

The first 150 words of the full text of this article appear below.

From BMJ USA 2002;September:484

The controversy about hormone replacement therapy (HRT) was not started but only renewed when the results of the Women's HealthInitiative (WHI) were announced in July.¹ In the WHI, 16 608postmenopausal women ages 50 to 79 were randomized to receiveestrogen plus progestin or placebo. Although the trial was plannedto last 8.5 years, the estrogen-progestin arm was stopped prematurelyafter 5.2 years because of increasedrisks.

The WHI reported a small but significantly higher risk of myocardial infarction (hazard ratio=1.32), stroke (HR=1.41), deepvein thrombosis (HR=2.07), pulmonary embolism (HR=2.13), and invasivebreast cancer (HR=1.26) in women receiving continuous conjugatedestrogen (0.625 mg) combined with medroxyprogesterone acetate.These relative risks seem small when translated into absoluterisks: for every 10 000 women-years of HRT there was an excessof 7 cardiac events, 8 breast cancers, 8 strokes, and 8 pulmonaryemboli. On the positive side, there were 6 fewer colorectal cancersand 5 fewer hipfractures.

These benefits . . . [Full text of this article]