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New data on hormone therapy must lead to re-evaluation of official guidelines
Date:10/18/2007

As opinion leaders in the field of menopause medicine from various areas in the world, we wish to emphasize the following points concerning postmenopausal hormone therapy:

  1. Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms and estrogen-deficient urogenital symptoms.

  2. The initial interpretation of the Womens Health Initiative (WHI) trial failed to recognize the immense importance of age and years since menopause on outcomes of HT. The potential impact of specific hormonal regimens on safety of HT should be considered as well.

  3. The results of the WHI trial were wrongly extrapolated to the whole postmenopausal population, which led to a major change in recommendations and guidelines on HT.

  4. Based on current knowledge, the balance between the benefits and risks of HT is clearly in favor of use in the early postmenopausal years for symptomatic, healthy women.

  5. All previous studies, including the WHI trial, have demonstrated significant positive effect on bone density and reduction in fracture risk among hormone users.

  6. Estrogen has favorable metabolic and cardioprotective effects in healthy, young postmenopausal women. The results for the age group 5059 years in the WHI estrogen-alone arm support this claim. Estrogen slows the pace of development of atherosclerosis if started in the early postmenopausal period.

  7. HT may be associated with a small increase in risk for breast cancer, if taken long term. Combined estrogenprogestogen therapy probably carries a higher risk than that recorded for estrogen alone. Prevalence of stroke and thromboembolism strongly correlates with age; therefore, the impact of the HT-related increased risk in this respect becomes more important in the late menopause. Low-dose estrogen or the transdermal route of administration may lead to a more favorable risk profile.

  8. Progestins, combined with estrogen, may d
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Contact: Jean Wright
jwright.ims@btopenworld.com
International Menopause Society
Source:Eurekalert

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