[After the early termination of the Women's Health Initiative study. New American recommendations for postmenopausal hormone therapy].
One treatment-arm of the Women's Health Initiative (WHI) study was recently terminated because the overall risks of hormone treatment were considered to outweigh the benefits. The main findings were an increased risk of venous thromboembolism and a decreased risk of osteoporotic fractures with treatment. No beneficial effects on cardiovascular disease could be detected. The North American Menopause Society (NAMS) Advisory Panel has given the following recommendations concerning hormone therapy: The primary indications are vasomotor and urogenital symptoms. The only indication for progesterone treatment is for endometrial protection. Hormones should not be prescribed for primary or secondary prevention of coronary heart disease. Alternative therapies should also be considered for the prevention of osteoporosis. A short duration of therapy and lower-than-standard doses are preferable. Establishing an individual risk profile is essential. The author of this article also emphasizes a restrictive attitude for patients with increased risk of thromboembolic disease.
Stjernquist
Martin
M
Institutionen för obstetrik och gynekologi, Malmö, Lunds universitet, kvinnokliniken, Universitetssjukhuset MAS, Malmö. martin.stjernquist@obst.mas.lu.se
D000368:Aged; D001943:Breast Neoplasms / Q000139:chemically induced; D003327:Coronary Disease / Q000517:prevention & control; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control; D017698:Postmenopause; D017410:Practice Guidelines as Topic; D045167:Progesterone Congeners / Q000008:administration & dosage / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016387:Women's Health
D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; D017258:Medroxyprogesterone Acetate