Withholding estrogen therapy cost tens of thousands of lives

Editor's Choice Academic Journal Main Category: Women's Health / Gynecology Also Included In: Menopause Article Date: 20 Jul 2013 - 0:00 PDT

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Nearly 50,000 women died unnecessarily over the last ten years because estrogen therapy was not given to patients aged 50 to 69 who had undergone a hysterectomy after the 2002 Women's Health Initiative (WHI) study.

In 2002, doctors and patients were seriously put off using HRT (hormone replacement therapy) because two trials - HERS and WHI - suggested that one type might raise the risk of cardiovascular problems. Up to that time, HRT had been seen as the savior for women who were in medical menopause; those who had undergone hysterectomy.

Dr. Philip Sarrel, emeritus professor in the Departments of Obstetrics, Gynecology & Reproductive Sciences, and Psychiatry, Yale University, and colleagues gathered and analyzed U.S. census data and hysterectomy rates, and estimated how much hormone replacement therapy had declined among female patients aged 50 to 59 between 2002 and 2011.

Before 2002, over 90% of these patients had been prescribed estrogen-only therapy for medical menopause symptoms, including hot flashes, as well as to prevent osteoporosis and other diseases caused by menopausal hormone deficiency.

Dr. Sarrel explained that the 2002 WHI study applied to women who took the combined estrogen plus progestin HRT - for patients with a uterus. Unfortunately, the study scared doctors away from any kind of HRT, including those who had undergone a hysterectomy.

Women who have a uterus (womb) are given the combination HRT because the progestin helps reduce the risk of cancer of the uterus.

Dr. Sarrel said:

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Withholding estrogen therapy cost tens of thousands of lives