Postmenopausal hormone therapy: have HERS2 and WHI given us any new information?
There still remains no consensus on the role of HRT in the initiation of breast cancer. Stimulation of an otherwise occult breast cancer leading to more frequently diagnosed breast cancers may seem more feasible and supported by the survival data. Although HERS and WHI both fail to offer support for a cardiovascular protective effect of HRT, other studies differ in their conclusions. There is still no true primary prevention randomized trial, and we may never have one. To take or not to take HRT may be one of the most important decisions a woman makes in her lifetime. For millions of women, now expected to live into their ninth decade, this is more than a theoretical question; it is a potentially life-altering one. For the majority of women, the cancer-phobia that leads to an avoidance of HRT is neither rational nor based on scientific evidence. However, there may be a relatively small subset of women for whom HRT does pose a potential health risk. Every health decision a woman makes includes such an assessment of risk balanced against benefit. It is the health provider's obligation to participate in risk assessment and assist each woman in designing a plan for life-long good health. The well-informed and consenting woman (and this is more important now than ever before) will make the correct decision for her circumstances. From a public health perspective, it is clear that more woman-years are saved as a result of the beneficial effects of HRT than are lost from its negative effects.
Fylstra
Donald L
DL
MUSC, 96 Jonathan Lucas St., Clinical Science Bldg. 634, Charleston, SC 29425, USA.
D002318:Cardiovascular Diseases / Q000517:prevention & control; D002986:Clinical Trials as Topic; D003657:Decision Making; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D009369:Neoplasms / Q000139:chemically induced; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control; D010353:Patient Education as Topic; D017698:Postmenopause; D011374:Progesterone / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D016387:Women's Health
D004967:Estrogens; D011374:Progesterone