Society for Women's Health Research's Expert Panel Builds Consensus on HT Guidelines
WASHINGTON, Jan. 31, 2013 /PRNewswire-USNewswire/ -- The Society for Women's Health Research (SWHR) today announced results of a recent scientific roundtable addressing hormone therapy (HT) in peri-menopausal, menopausal and post-menopausal women that has the potential for practice-changing outcomes.
The HT Scientific Roundtable, composed of international researchers, explored the concerns and confusion surrounding the complex issue of menopausal hormone therapy. Unlike previous reviews of the literature, this group examined the most recent and broadest group of studies available and provided recommendations, for the first time, based on the stage of life a woman begins HT. In addition, the group provided an analysis of the benefits and risks of hormone therapy and made recommendations for future research and clinical care.
"There has been a tremendous amount of research conducted over the past decade, and the results vary greatly, depending on the type of hormone therapy used and time in the menopausal transition that a woman initiates treatment," said Shelley Salpeter, M.D., Clinical Professor of Medicine at Stanford University and panel participant. "Our goal was to establish clearer recommendations for women so they can get the appropriate treatment they need without concerns about jeopardizing their health."
Key findings include:
- Roundtable participants unanimously agreed that the benefit risk profile of HT is more favorable for younger, newly menopausal women.
- The panelists agreed unanimously that HT provides a significant benefit on quality of life (QOL) measures (MS-QOL, HRQOL) in early postmenopausal women, mainly through the relief of symptoms, but treatment also may result in a global increase in a sense of well-being (GQOL).
- Majority of panelists agreed there is consistent evidence that in early postmenopausal women, hormone therapy reduces total mortality. Most importantly, this panel uniquely distinguished between ages beginning HT versus extrapolating data to all women.
- Majority agreed that in younger symptomatic postmenopausal women the benefits of estrogen and progestin for at least five years outweigh the risks, which gives formal guidance on duration for the first time.
- Panelists unanimously agreed that in younger postmenopausal women with hysterectomy, the benefits of unopposed estrogen treatment for at least 10 years outweigh the risks. Treatment recommendations for this group of women have not been specifically addressed in other recent reports.
- Majority agreed that HT in early postmenopausal women does not increase the risk for coronary heart disease (CHD), and may reduce it. However, there is insufficient evidence for the use of HT in the primary prevention of coronary heart disease. Again, this provided guidance to younger women, unlike previous reports.
- Unlike other reports, the panel (with the exception of two abstaining votes) agreed that estrogen can be used for the prevention of osteoporosis (an FDA approved indication), in early postmenopausal women at increased risk of fracture. The optimal duration for treatment is not known. If HT is discontinued the benefits dissipate. Therefore, in patients at high risk for osteoporotic fractures, continued estrogen treatment or other alternative treatments should be considered. Some previous reports have said HT was not appropriate for the prevention of any chronic disease.
"One of the major misunderstandings surrounding hormone therapy is the belief that all hormone therapy is the same, but in fact, there can be drastic differences among therapies based on age of first use, dosage and method of delivery. What is appropriate for one woman may not be for another," said Phyllis Greenberger, President and CEO of SWHR, a national non-profit organization dedicated to improving women's health. "We hope these new guidelines will help women have a clearer understanding of their entire range of treatment options, potential benefits and likelihood of possible risk."
About the HT Roundtable
A group of 18 research scientists, clinicians and leading medical program directors uniquely qualified to provide recommendations in the areas of menopause symptoms, Alzheimer's disease, cardiovascular disease, osteoporosis and cancer, reviewed the most rigorous scientific research available on hormone therapy. Seventeen of these experts convened and discussed their findings on November 30, 2012 in Washington, D.C. The full list of participants is available online at http://www.womenshealthresearch.org/HTroundtable. This scientific roundtable was made possible by an unrestricted educational grant from Pfizer, Inc.
Dispelling Mixed Messages about Hormone Therapy
In 2002, a landmark National Institutes of Health study reported that post-menopausal women taking hormone therapy were at an increased risk of invasive breast cancer, heart attacks, stroke, pulmonary emboli, deep vein thrombosis and dementia. Since 2002 – a full decade ago – there has been significant research that contradicts the findings in the Women's Health Initiative studies. As a result, the WHI studies may not apply to certain groups of women, or in some cases may no longer be valid.
The Society for Women's Health Research (SWHR) is the thought leader in research on biological differences in disease and is dedicated to transforming women's health through science, advocacy and education. Visit SWHR's website at www.womenshealthresearch.org for more information.
SOURCE Society for Women’s Health Research