Wednesday, January 21, 2004
| Topic: |
Hormone Replacement Therapy: What Went Wrong? |
| Presenter: |
Cynthia A. Stuenkel, MD,
Clinical Professor of Medicine, Endocrine and Metabolism
Mary Devereaux,
Research Ethics Program |
| Location: |
Medical Teaching Facility (MTF) 175 |
Discussion
Questions: |
- For years doctors prescribed powerful drugs (HRT) to a large patient population in the belief that estrogen alone, or in combination, would protect against heart disease, osteoporosis and other diseases. Recent studies (e.g.,The Women's Health Initiative) fail to support such claims. What aspects of medical practice led so many doctors to "get it wrong for so long"?
- Were there clinical warning signs that should have gained greater attention earlier, but didn't? And if so, what happened?
- What role did cultural views about women, female reproduction and aging play in contributing to this outcome?
- What role did pharmaceutical interests play in encouraging the widespread use of HRT for menopausal and post-menopausal women?
- What can we learn from this episode from a public health/clinical standpoint? How, for example, ought new (and unexpected) medical results best be handled in the future?
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Discussion
Summary |
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| Readings: |
- Writing Group for the Women's Health Initiative. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA 2002; 288:321-333. Editorial p. 366
- Grostein F, Clarkson T, Manson J. Understanding the divergent data on postmenopausal hormone therapy. N Engl J Med 2003; 348:645-650
- Barrett-Connor E. An epidemiologist looks at hormones and heart disease in women. J Clin Endocrinol Metab 2003; 88:4031-4042
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