Summary of the Article: A Critical look at Menopausal Hormone Therapy
This article presents a critical examination of the cyclical promotion and subsequent questioning of menopausal hormone therapy (HRT). Here’s a breakdown of the key points:
* Early Beliefs vs. Reality: In the 1990s, HRT was widely used, ofen believed to prevent chronic disease. Though, studies revealed that hormone users weren’t healthier as of the hormones, but rather exhibited healthier lifestyles (wealth, exercise, non-smoking, lower blood pressure) to begin with.
* The Importance of Randomized Controlled Trials: The author emphasizes the necessity of randomized controlled trials (RCTs) to determine true benefits, as observational studies can be misleading. The FDA initially rejected approving hormones for cardiovascular disease prevention due to a lack of RCTs.
* The Women’s Health Initiative (WHI): This large-scale RCT (over 26,000 women) revealed that HRT didn’t reduce cardiovascular disease risk and, in fact, caused harm – increasing the risk of strokes, blood clots, and breast cancer. The trials were halted early due to these harms.
* The Current Resurgence of HRT Promotion: The article notes a renewed push to promote HRT, fueled by telehealth companies, media (Oprah, “The M Factor” movie), and articles touting its benefits for longevity and well-being.
* FDA’s Controversial Decision: The author criticizes the FDA’s recent decision to remove the “black box” warning on HRT products, despite a lack of new evidence supporting this change. The warning previously highlighted risks of breast cancer, dementia, and heart attacks.
* Nuances & Caveats: The article acknowledges some nuances,such as a potential decrease in breast cancer risk with estrogen-only therapy in women who’ve had hysterectomies,and that heart attack risk may be higher initially but equalize over time. However, it maintains a skeptical stance overall.
In essence, the article warns against repeating past mistakes and urges caution regarding the current wave of HRT promotion, emphasizing the importance of evidence-based medicine and acknowledging the potential harms associated with hormone therapy. It suggests the current enthusiasm is driven by marketing and a cyclical pattern of belief, rather than solid scientific evidence.
