HORMONE REPLACEMENT THERAPY

In the past, hormone replacement therapy used to be commonly prescribed in women with severe menopausal symptoms, for the treatment of these symptoms as well as for their beneficial effects on osteoporosis, coronary heart disease and colorectal cancer.

However, in recent years, the use of HRTs has decreased significantly due to the findings of a very large study, called the Women's Health Initiative (WHI).

THE WOMEN'S HEALTH INITIATIVE (WHI) STUDY

The Women's Health Initiative (WHI) Study is a very large randomised controlled trial on one combination of HRTs. Conjugated equine estrogen 0.625mg plus medroxyprogesterone acetate 2.5 mg was compared against a placebo in 16,608 healthy postmenopausal women aged between 50 to 79 years, with an intact uterus from 40 North American centres over a planned 8.5 years. One of the study's components examined the role of HRT in the prevention of major degenerative diseases (cardiovascular disease, osteoporosis and cancer).

This component of the WHI Study was stopped prematurely on 31st May 2002, after 5.2 years by the data and safety monitoring board, due to an increased risk of invasive breast cancer, cardiovascular disease, strokes and pulmonary embolism. Reduction of risks were observed in endometrial cancer, hip fractures and colorectal cancers. Since the overall health risks exceeded the benefits, it was concluded that combined estrogen-progesterone is probably only suitable for short term treatment of early menopausal women with significant menopausal symptoms. In general, menopausal symptoms will resolve within 5 years spontaneously.

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