Interview with Rowan Chlebowski, MD a lead investigator of the Women's Health Initiative
Rosenberg: The Women's Heath Initiative findings about hormone therapy (HT) were definitive enough that both the estrogen and estrogen plus progestin arms of the study were terminated. Yet claims of heart and memory benefits for women, if HT is started early enough, continue in the media. Is there new information that has changed the risk/benefit ratio?
Chlebowski: The new information was a secondary analysis of WHI data which ran in JAMA in 2007 and found HT may not be as detrimental for coronary heart disease as previously thought, if started in early menopause. Risk for stroke did not change, however, and there are indications that breast cancers appeared earlier, when hormones were started earlier.
Rosenberg: Why are some doctors and Continuing Medication Education courses presenting HT as cardioprotective?
Chlebowski: That claim is heard more from the gynecological community which had been the biggest HT prescribers rather than from the general medicine or the oncology community. The FDA has not changed the prescribing label on the basis of the WHI secondary analysis. HT is still not a desirable chronic disease risk reduction agent though for short term relief of vasomotor systems like hot flashes no other therapy comes close.