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NIH Convenes Hormone Therapy Conference

By Ellyn Pollack

Photos by Ernie Branson

Long-term use of the estrogen plus progestin combination — one of the most commonly prescribed hormone regimens — does not prevent cardiovascular diseases and other chronic conditions in postmenopausal women. In fact, the risks (increased breast cancer, heart attacks, strokes and blood clots in the lungs and legs) outweigh the benefits (fewer hip fractures and colon cancers). This was the finding of a recent NIH scientific workshop on Menopausal Hormone Therapy, which featured the world's leading experts on the subject.

Dr. Marcia L. Stefanick (l) of Stanford University and Dr. Marian C. Limacher of the University of Florida College of Medicine participate in a panel discussion of the WHI data.

The purpose was to review results from one component of the Women's Health Initiative (WHI) clinical trial — an NIH study that was halted in May 2002 due to an increased risk of invasive breast cancer and cardiovascular disease — and place these results in the context of other completed and ongoing research on menopausal combination hormone therapy. The goal of the meeting was to assess what researchers know about the use of menopausal hormone therapy, particularly as a preventive agent, and decide what questions still need to be addressed through further research.

Dr. L. Natalie Carroll, president of the National Medical Association, speaks during the discussion on implications for research.

HHS Secretary Tommy Thompson addresses the audience on day two of the scientific workshop.

"There is not a simple, single answer for all women," said Dr. Elias Zerhouni, NIH director. "However, the WHI results do help simplify and clarify — not complicate — the decision-making process. Women now have information from a randomized clinical trial — the gold standard for evidence-based medicine. Combined hormone therapy should no longer be considered the effective prevention strategy against chronic diseases."

Women who are considering whether to start or continue hormone therapy to relieve menopausal symptoms need to consider the findings from this and other studies, and discuss with their health care provider their individual risk for specific chronic conditions and their personal preferences. The workshop, which was attended by nearly 800 people, may be viewed online at http://videocast.nih.gov/PastEvents.asp?c=1. For more information on hormone therapy, go to the NIH menopausal hormone page at http://www.nih.gov/PHTindex.htm.

Former NIH director Dr. Bernadine Healy established the Women's Health Initiative in 1991. NIH director Dr. Elias Zerhouni opened and closed the workshop.

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