|The Oestrogen only arm of the Women's Health Initiative (WHI) trial has been stopped after almost 7 years, partly because it was felt that completion to the planned date of 2005 would be unlikely to provide further information. This part of the study involved 11,000 healthy, postmenopausal women aged 50 to 79 who had had a hysterectomy and were randomly allocated oestrogen (0.625mg conjugated equine oestrogen) or placebo.
Full results are expected to be reported over the next 2 months but preliminary results have shown a small increased risk of stroke (an extra 8 cases per 10,000 women per year), no increase or decrease in risk of heart disease or breast cancer, and a small decrease in risk of hip fracture. The increased stroke risk is similar to that found in the combined oestrogen/progestogen arm of the trial, reported in July 2002.
These results should not cause undue panic but should continue to encourage women to discuss the risks and benefits of HRT at a regular review with their health professional. Women in this study were not suffering from menopausal symptoms and were not thought to be at increased risk of osteoporosis: the 2 licensed indications for HRT. They were also generally older than women who usually use HRT in the UK and therefore thought to be at a higher absolute risk of stroke.
When HRT is used appropriately for its licensed indications with regular review, the benefits will continue to outweigh the risks for many women but women must be able to make informed choices about their menopause.
For full report from National Institutes of Health:
Statement from the British Menopause Society: