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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Risks and benefits of hormone therapy: Has medical dogma now been overturned?
Climacteric, Volume 17, No. 3, Year 2014
Notification
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Description
Background In an integrated overview of the benefits and risks of menopausal hormone therapy (HT), the Women's Health Initiative (WHI) investigators have claimed that their 'findings ... do not support use of this therapy for chronic disease prevention'. In an accompanying editorial, it was claimed that 'the WHI overturned medical dogma regarding menopausal [HT]'. Objectives To evaluate those claims. Methods Epidemiological criteria of causation were applied to the evidence. Results A 'global index' purporting to summarize the overall benefit versus the risk of HT was not valid, and it was biased. For coronary heart disease, an increased risk in users of estrogen plus progestogen (E + P), previously reported by the WHI, was not confirmed. The WHI study did not establish that E+ P increases the risk of breast cancer; the findings suggest that unopposed estrogen therapy (ET) does not increase the risk, and may even reduce it. The findings for stroke and pulmonary embolism were compatible with an increased risk, and among E+ P users there were credible reductions in the risk of colorectal and endometrial cancer. For E+ P and ET users, there were credible reductions in the risk of hip fracture. Under 'worst case' and 'best case' assumptions, the changes in the incidence of the outcomes attributable to HT were minor. Conclusions Over-interpretation and misrepresentation of the WHI findings have damaged the health and well-being of menopausal women by convincing them and their health professionals that the risks of HT outweigh the benefits. © 2014 International Menopause Society.
Authors & Co-Authors
Shapiro, Samuel M.
South Africa, Cape Town
Faculty of Health Sciences
de Villiers, Tobias J.
South Africa, Stellenbosch
Stellenbosch University
Pines, Amos
Israel, Tel Aviv-yafo
Tel Aviv University
Sturdee, David W.
United Kingdom, Solihull
Solihull Hospital
Baber, Rodney J.
Australia, Sydney
The University of Sydney
Panay, Nick
United Kingdom, London
Chelsea and Westminster Hospital
Stevenson, John C.
United Kingdom, London
Royal Brompton Hospital
Mueck, Alfred Otto
Germany, Tubingen
Eberhard Karls Universität Tübingen
Burger, Henry G.
Australia, Clayton
Monash University
Statistics
Citations: 20
Authors: 9
Affiliations: 9
Identifiers
Doi:
10.3109/13697137.2014.905529
ISSN:
13697137
e-ISSN:
14730804
Research Areas
Cancer
Noncommunicable Diseases
Sexual And Reproductive Health
Study Design
Cohort Study
Participants Gender
Female