USA Today Examines Criticism of Women’s Health Initiative Study on Benefits, Risks of Estrogen in HRT for Postmenopausal Women
USA Today on Thursday examined criticism of the Women’s Health Initiative study that found that estrogen in hormone replacement therapy increases a woman’s risk for heart disease and stroke. Critics said one of the problems with the WHI study is that the average age of participants was about 63, by which time, estrogen in HRT might not be as effective in preventing the plaque buildup that can cause heart attacks and strokes.
Critics also said that the initiative tested Wyeth’s Premarin and Prempro, which contain estrogen from pregnant mares’ urine, but did not test using estradiol, an estrogen made by premenopausal women’s ovaries, which they said might produce different results. However, WHI researchers said that about 30% of hormone trial participants were between ages 50 and 60 when they enrolled in the trial and noted that Premarin and Prempro were more widely sold than other postmenopausal HRTs. Although the WHI results led FDA to begin advising women to take HRT only to reduce menopausal symptoms and then only to take the lowest dose for the shortest amount of time, “a coterie of gynecologists and other researchers refuse to give up on estrogen,” according to USA Today. Two ongoing studies — the Kronos Early Estrogen Prevention Study and the Early Versus Late Intervention Trial with Estradiol — will examine the differences in heart attack rates for postmenopausal women ages 42 to 58 who are taking estrogen and assess plaque buildup in arteries with X-rays and/or ultrasound. Some researchers — including menopause researcher Deborah Grady, a University of California-San Francisco internist who was not part of WHI — said, “If it’s true that estrogen is helpful right around menopause, maybe that’s scientifically interesting,” adding, “What then? You take it from 50 to 59? Then at some point it becomes dangerous? … How do we figure it out?” (Rubin, USA Today, 2/23).