Dr. Regine Sitruk-Ware shares if she agrees with the WHi findings on hormone therapy.
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The Women’s Health Initiative was extraordinary undertaking, very large study which had the objective of determining whether a certain type of hormone therapy would prevent several kind of disease and replace the hormone missing in the body and still improving life of women. Unfortunately, the study showed only negative outcomes. The reasons were that the population selected for the study was rather older than the menopausal women. When they come to the stage where they had their last menses and they had symptoms, and they need help. The Women’s Health Initiative had a population where the mean age was 63, and it’s not at that time that the woman starts to consult the physician. In addition, there was only one kind of hormone which was the treatment selected in the study at a rather high dose for a population of age 65 and over, and because a large proportion of these women were in the study already with lesions in their arteries and disorders in their brain cells. These treatments, at a higher dose for them, have increased the risk. Unfortunately, the message that went was that all hormones for all women were bad, and this is wrong. I think if the treatment is given during a good window of opportunity, which is during the ten years following the last menstrual period when the women really start to have symptoms, at an appropriate dose, respecting the contra indications, then the benefits are huge. And it can improve not only the bone protection but also decrease cardiovascular risk and improve brain function, and this was demonstrated in the younger age groups.
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