WHI misinformation on HRT

WOmen were led to believe that taking HRT had serious consequences for them, as a result of the WHI trial in the early 2000s. As a result many women stopped their HRT and suffered severely. We now know that the WHI had got it seriously wrong. This article asks why:

Climacteric. 2012 Aug;15(4):320-5.
A decade post WHI, menopausal hormone therapy comes full circle – need for independent commission.
Utian WH.

Consultant in Women’s Health, Executive Director Emeritus, The North American Menopause Society; Professor Emeritus, Reproductive Biology, Case Medical School , Cleveland, Ohio , USA.

ABSTRACT The sudden decision by the National Heart, Lung, and Blood Institute of the National Institutes of Health to terminate the estrogen-progestogen therapy arm of the Women’s Health Initiative (WHI) Study a decade ago now begs two questions: – has women’s health after menopause been helped or harmed as a result of the findings and the way in which they were presented, and, if harmed, what needs to be done to put things right? Time and multiple reviews of specific publications from the WHI lead to the serious question whether a project designed to be of benefit to women’s health has boomeranged, and instead may have resulted in significant impairment to both the quality of life and physical health of postmenopausal women. It is therefore urgent to confirm whether this is so and whether corrective action needs be taken to prevent even more harm. There are two obvious and immediate actions to be called for: (1) The Food and Drug Administration (FDA) needs to revisit the black-box warnings on postmenopausal hormones. Specifically, there needs to be a separation of the advisories for estrogen alone from estrogen and progestogen combined usage. (2) Justification is given to call for an independent commission to scrutinize every major WHI paper to determine whether the data justified the conclusions drawn. Women progressing through and beyond menopause in the next decade need to be spared the unnecessary harm that may have been inflicted on their sisters of the previous decade.

About Dr Colin Holloway

Gp interested in natural hormone treatment for men and women of all ages

Posted on July 31, 2012, in Uncategorized. Bookmark the permalink. 4 Comments.

  1. Monika Merkes

    (Honorary Associate, Australian Institute for Primary Care & Ageing at La Trobe University)

    Sue, I am in the no-screening group. I’ve made that decision after extensive reading of the peer reviewed literature. Should I ever discover any symptoms, I’ll use the same process to decide what to do next.
    I’m privileged to be able to do this: I have access to research articles behind the pay wall, I have a PhD in public health and am reasonably confident I understand the articles I read, and I have the time to do this. Other women may come to a different conclusion; I’m not saying my decision to stay away from breast cancer screening is right for every woman.
    Easy to understand full disclosure of the benefits and harms of mammography screening like this article or the Nordic Cochrane Institute leaflet must be available to all women. And their health care providers should take the time to discuss it with them.

  2. Steve

    Do the authors have any comment on the The Nordic Cochrane Center’s leaflet on mammography that was released this year?

    Some of it’s conclusions:

    “If 2,000 women are screened regularly for 10 years, one will benefit from screening….If 2,000 women are screened regularly for 10 years, 10 healthy women will be turned into cancer patients and will be treated unnecessarily.”

    Click to access mammography-leaflet.pdf

  3. Dan

    Fantastic article. Going astray in the sometimes counterintuitive world of statistics can have serious repercussions in fields like medicine and law, ironically two fields that really need and benefit from stats. The lead-time bias is something I hadn’t come across before.

    Your probability tree is a good visualisation of the strange world of base rate fallacies. For anyone out there interested in more of these kinds of mathematical gotchas and real-world implications, I can recommend John Allen Paulos’s book “Innumeracy” (no heavy maths required.)

  4. Monika,

    Thank you for this informative and clear article. Women who participate in mammography screening should be provided with information about the risks and benefits of screening in a way that is easily understood and contributes to informed decision-making.

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