Use of menopausal hormone therapy (HT) fell precipitously after 2002, largely as a result of the Women's Health Initiative's report claiming that the combination of conjugated equine estrogen (CEE) and medroxyprogesterone acetate increased breast cancer risk and did not improve quality of life. More recently, Women's Health Initiative (WHI) publications acknowledge HT as the most effective treatment for managing menopausal vasomotor symptoms and report that CEE alone reduces the risk of breast cancer by 23% while reducing breast cancer death by 40%. Their sole remaining concern is a small increase in breast cancer incidence with CEE and medroxyprogesterone acetate (1 per 1,000 women per year) but with no increased risk of breast cancer mortality.
View Article and Find Full Text PDFThis article reviews the decades of evidence supporting the reproducible benefits of HRT for menopausal symptom control, improved cardiac health, prevention of hip fracture, reduction in the risk and pace of cognitive decline, and enhanced longevity. It quantifies the increased risk of thromboembolism associated with oral, though not transdermal, HRT. It evaluates the repeated claims that HRT is associated with an increased risk of breast cancer development, and, when administered to breast cancer survivors, an increased risk of breast cancer recurrence.
View Article and Find Full Text PDFBreast Cancer Res Treat
February 2022
From 2002 to 2008, reports from the Women's Health Initiative (WHI) claimed that hormone replacement therapy (HRT) significantly increased the risks of breast cancer development, cardiac events, Alzheimer disease, and stroke. These claims alarmed the public and health professionals alike, causing an almost immediate and sharp decline in the numbers of women receiving HRT. However, the actual data in the published WHI articles reveal that the findings reported in press releases and interviews of the principal investigators were often distorted, oversimplified, or wrong.
View Article and Find Full Text PDFRecent reports attributing a significant increased risk of breast cancer development, cardiac events, and Alzheimer's disease to the administration of estrogen-progestin hormone replacement therapy (HRT) require critical review, not blind acceptance. An appreciation of the numbers used to generate these conclusions, the abundance and strength of the studies that do not support them, the small size of the effect reported, even if arguably valid, and the persisting reported benefit of HRT on longevity should alert clinicians to the risks of accepting these studies as guidelines for patient management. The additional report from this same group that HRT has no effect on health-related quality of life deserves a good laugh, not serious consideration.
View Article and Find Full Text PDF