The turbulent seas of women’s health—who is the beneficiary?

Abstract

I read with unusual mix of relief, encouragement and dismay the recent NIH report terminating the estrogens-only arm of the WHI study. It has been concluded that in a randomized placebo controlled trial, estrogen alone in hysterectomized women does not increase the risks of breast cancer or cardiovascular disease, reduces the incidence of hip fractures and that of colon cancer. These controversial issues have dogged the practice of postmenopausal hormone replacement therapy over the last two decades. As such these news have relieved a great deal of the concern about the long-term effects of estrogen therapy and encouraged all workers in the field to continue to develop the service. I attribute the sense of dismay caused by the trial termination to the missed opportunity to see the trial to its prescribed end in order to unambiguously advise postmenopausal women, since funding for another WHI is unlikely to materialize in the near future. Their decision was based on a rather feeble argument on the finding of extra 8:10,000 cases of stroke in the estrogen treated arm that proved “unacceptable” to the committee.