As you know, the Women's Health Initiative (WHI) research in 2002 totally reversed medicine's thinking about hormone therapy.  Prior to WHI we thought hormone replacement therapy (HRT) was a healthy anti-aging option for women.  After the release of WHI, we considered hormones a death sentence through their causation of heart attacks, strokes and breast cancer.  My simplistic mind could never understand how natural low dose hormones from a woman's ovaries could be so deadly (as compared to their absence), but some 40 million women stopped their hormones due to this flawed research and the resulting media hype which followed. 

Dr. Leon Speroff, one of gynecology's "thought leaders" has come out recently with an editorial which attacks this subject by asking the question, "How much harm has been done."  Read more of his thoughts just below:

What have we learned from the WHI 
 
May 1, 2007 
Leon Speroff, MD 
 
After reading the latest report from the Women's Health Initiative (WHI), I've struggled with my emotional reaction. Without success, I've tried to suppress my anger. I ended up wondering: "How much harm has been done?"

The WHI investigators conducted a secondary analysis, assessing cardiovascular results by age groups (50–59, 60–69, and 70–79) and according to years since menopause (<10, 10–19, and =20)

An increased risk for coronary heart disease (CHD) was present only in the oldest women in the trials. The authors calculated absolute risks and found no increases for heart disease, stroke, or total mortality in women aged 50 to 59. In fact, only the increase in heart disease events in women 20+ years since menopause reached statistical significance. The authors concluded that there was no apparent increase in cardiovascular disease risk in treated women close to their menopause.

The data in this WHI report are not new.  What is new is that the WHI is finally reporting this finding to the public, almost 5 years since the first dramatic publication in July 2002.

Do these results rule out the possibility that hormone therapy given to young postmenopausal women may prevent coronary heart disease? I think not. There continues to be a growing story that adequate estrogen exposure prior to the clinical presence of atherosclerosis provides protection against cardiovascular disease. How many heart attacks and fractures will be documented in the coming years arising in the population of women who discontinued their hormone therapy following the WHI publicity?

Click Here For The Complete Story=>  http://www.contemporaryobgyn.net/obgyn/article/articleDetail.jsp?id=426598

Another and more provocative story on the same subject from England (where the politics may have less influence) is printed next:

U-turn on the risks of HRT as experts say it CAN cut heart disease

04.09.07

Stressful times, but experts are now saying HRT does not increase the risks of heart disease and strokes. 

Millions of women may have been scared into abandoning HRT unnecessarily according to a new report.  The U.S. report which linked the treatment to heart disease and strokes has been shown to be dramatically flawed. 

A detailed new look at its research results revealed that hormone replacement therapy may actually protect many patients against such illnesses.  British experts said the revised analysis of the Women's Health Initiative Study virtually reversed the 2002 warning that led millions of women to stop HRT or not start it.  

It has discovered that any extra risks may apply only to older patients - with HRT actually boosting the health of the women in their 50s who are most likely to use it to fight symptoms of the menopause.  Their risk of stroke is no higher and their risk of dying prematurely is actually 30 per cent lower.

Dr John Stevenson, an HRT expert from London's Royal Brompton Hospital, launched a furious attack on the original researchers and warned that women who stopped taking hormones would go on to suffer heart attacks and other illnesses they 'didn't deserve'.  He said: "This is a U-turn of dramatic proportions. These conclusions are at complete variance with the widely-publicised 2002 results on which our guidance on prescribing is based.  "We are astonished that a study which made such a claim for the dangers of HRT is now showing just the opposite. It is an affront to science, adding insult to injury for the thousands of women in the UK alone who abandoned HRT."

Patrick Shervington, of the charity Women's Health Concern, said the original analysis "dissuaded both women and their doctors from using HRT, with the result that thousands of women have suffered menopausal complaints and may have done untold harm to their future health".

HRT, which can take the form of pills, patches or a nasal spray, is known to protect against the bone-thinning disease osteoporosis and may even stave off the development of Alzheimer's disease in later life.

The 2002 trial looked at the overall health of more than 16,000 women between 50 and 79, half of whom took HRT.  It reported that those on HRT were 29 per cent more likely to have heart problems, 41 per cent more likely to have a stroke and at 26 per cent greater risk of breast cancer.  The researchers were so concerned about their health that the trial was stopped three years early.

British doctors pointed out at the time that most of the women taking part were much older than those typically given HRT.  But the safety fears led to UK doctors being told to prescribe the treatment for the shortest period possible. The number of women taking HRT any one time halved to just 900,000.

The latest analysis, carried out by many of the same researchers and published in the respected Journal of the American Medical Association, looked at the same results.  Crucially, however, it focused for the first time on whether the health effects varied with age.

Wide differences were quickly discovered. It emerged that women who start HRT  shortly after the menopause are not more likely to get heart problems. Their risk is actually 24 per cent lower than those not using hormones.

They also have a lower risk of dying, so for every 10,000 women from 50 to 59 using hormones there would be 10 fewer deaths than among 100,000 non-users.

In contrast, women who start HRT 20 years or more past the menopause face a 28 per cent higher risk of heart problems.

It is thought that if HRT is taken early, when the arteries are still relatively healthy, it may protect against heart problems developing.  Taken later in life, when the arteries are more likely to have suffered damage, it may make matters worse.

The new analysis did not look in detail at the breast cancer dangers, although it found that younger women taking the form of HRT which combines oestrogen-with synthetic progesterone were at greater risk.  But Dr Stevenson said the link with breast cancer was still unclear and any increased risk was 'incredibly small'.

He added: "The latest analysis confirms what most European clinicians have been saying, namely that the HRT used in the study was appropriate and beneficial for women under 60.

"The study says these women have a lower risk of coronary disease, a lower risk of death from any cause and no increased risk for stroke.  "There have to be women who, in years to come, are going to get a fracture they didn't deserve or a heart attack they didn't deserve."

Dr Stevenson, who is also a member of the British Menopause Society and Women's Health Concern, called on the Medicines and Healthcare products Regulatory Agency, which is responsible for drug safety, to consider the new findings 'as a matter of urgency'.

The MHRA said last night: "We look at all new research in this area and will issue further advice if necessary."

Click Here For The Complete Story=>   http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=447476&in_page_id=1770

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