A Decade Later, HRT Deemed Okay for
Mayfield Heights, OH
Some Menopausal Women
—Hormone therapy for menopausal women may be safe after all.
A decade after the Women's Health Initiative (WHI) published its assessment of hormone therapy for the prevention of chronic disease and concluded that risks exceeded benefits, 15 medical organizations have agreed on
a joint position
that hormone therapy can be acceptable treatment for menopausal symptoms in certain situations.
was prepared by The North American Menopause Society (NAMS), the American Society for Reproductive Medicine (ASRM), and The Endocrine Society, and endorsed by 12 other women’s health groups.
"We believe that too many symptomatic women are missing out on the proven benefits of hormone therapy because the results of the WHI, which studied the long-term use of hormones to prevent chronic disease, were misinterpreted for women with menopausal symptoms" said Margery Gass, MD, NAMS executive director. "Women and clinicians are frustrated by the many conflicting recommendations. That's why we initiated this effort to bring these notable medical organizations together in agreement regarding the use of hormone therapy."
The groups suggest that hormone therapy is “acceptable and relatively safe for healthy, symptomatic, recently postmenopausal women.” After the WHI results were highly publicized, many gynecologists stopped prescribing hormone treatment all together, and menopausal women had to seek other symptom relief, including alternative therapies.
"Physicians can help patients determine, based on their own particular characteristics and history, whether or not they are good candidates for hormone therapy and what type of HT will provide them the greatest relief at the lowest risk,” added Roger Lobo, MD, past president of the American Society for Reproductive Medicine. “A decade of research and analysis has shown us that the generalized conclusions of the WHI do not apply to younger women at the beginning of the menopausal transition."
The societies agree on the following points:
• Hormone therapy is an acceptable option for the relatively young (up to age 59 or within 10 years of menopause) and healthy women who are bothered by moderate to severe menopausal symptoms.
• Vaginal estrogen is the preferred treatment if vaginal dryness or discomfort with intercourse are the only complaints.
• While women who have had their uterus removed can take estrogen alone, women with uteruses need to also take progestogen to prevent cancer of the uterus.
• As with birth control pills, patches, and rings, estrogen therapy (even combined with progestogen) increases the risk of blood clots in the legs and lungs. The risk is rare, however, in women ages 50 to 59.
• Continuous estrogen with progestogen therapy for 5 or more years, or possibly even less time, raises the risk of breast cancer, although the risk decreases after hormone therapy is stopped.