Professor Robert D Langer’s paper, ‘The evidence base for HRT: what can we believe?’ is a review of the 2002 Women’s Health Initiative (WHI) clinical trial of hormone replacement therapy (HRT). The study and its findings, you may recall, emphasised the risks of HRT causing worldwide concern and led to many women refusing or stopping treatment.
Professor Langer’s paper highlights the serious errors that were made during the WHI study including:-
- Publication of results with very little involvement from the key investigators.
- Reported conclusions that did not accurately reflect the scientific findings
- Although the study was designed to test the effects of HRT in older women – the conclusions applied the exaggerated risk to all women.
As a consequence many women who needed HRT have avoided it and subsequently suffered unnecessarily.
Since then many clinicians have been trying to disprove the findings of the report.
Professor Langer says “in the years since the first WHI report, we have learned much about the characteristics of women who are likely to benefit from HRT. The range of HRT regimens has also increased. Not all women have indications for HRT, but for those who do and who initiate within 10 years of menopause, benefits are both short-term (vasomotor, dyspareunia), and long-term (bone health, coronary risk reduction).”
Things have indeed moved on a great deal since this study. In November 2015, NICE (National Institute for Health and Clinical Excellence) UK, issued the first guideline on diagnosis and management. You can find the guideline for professionals and a simplified version for women patients here.
See Professor Robert D Langer’s paper: ‘The evidence base for HRT: what can we believe?’ http://www.tandfonline.com/doi/full/10.1080/13697137.2017.1280251