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Hormone replacement therapy: where do we go from here?

In July 2002, the National Institutes of Health closed a portion of the Women’s Health Initiative that was studying the relationship between hormone replacement therapy (HRT) and its possible risks and benefits. The study had involved 16,608 healthy women, ages 50 to 70, who took either estrogen and progestin or a placebo. Women’s Health Initiative (WHI) stopped the study when it identified small but significantly increased risks of breast cancer, coronary artery disease, stroke, and vascular events. The benefits included lower risk of fractures and colon cancer. There was no difference in the death rates between the group on combined HRT (cHRT) and the group taking placebo. ‘‘The ground rules have changed in how to prescribe hormone replacement therapy,’’ Dr. Mary Jackson said. The purpose of her presentation at the Primary Care Conference was to review the findings and to help health professionals determine how to advise their patients who ask, ‘‘What do I do now?’’