Hi Gerald, You may want to check in with women's health clinicians on this topic. The study that advised against hormone replacement therapy was poorly done and created a lot of issues for women who, for one reason or another, needed to have a hysterectomy. Physicians have been struggling to undo the damage done by that "study" since then.
Yes, lots of confusing information out there. I was under the impression that HRT was okay once again--except for women with breast cancer, or a high risk for blood clots.
It's good to know the forces behind removing the black box warning.
Are there black box warnings for cross-sex hormone use? (Sometimes known as gender-affirming care, more like risky extreme body modification.)
Instead of reflexively condemning this decision because of the current administration— read and review the current literature and recommendations!!
The FDA’s update reflects evidence-based progress, not recklessness. This article by the Posners is poorly researched and misrepresents the decision to remove black-box warnings on hormone replacement therapy (HRT) for perimenopausal women. It relies on outdated interpretations of the Women’s Health Initiative (WHI) study.
Over the past decade, extensive parsing of the WHI data, published in JAMA, has clarified the timing of HRT.
If initiated before age 60 in women with intact estrogen receptors, HRT significantly reduces cardiovascular risk by up to 50 percent, lowers all-cause mortality, and, with estrogen alone, decreases breast cancer risk by 23 percent.
The ACOG, the Endocrine Society, and NAMS, now recommend individualized HRT for symptom relief and long-term health protection because of
benefits including 75-90% reduction in vasomotor symptoms, 50-60%
There are of course risks which include minimal breast cancer increase with combined estrogen- progesterone therapy
with one additional case per 1,000 women annually,
and rare cases of venous thromboembolism which is reduced by transdermal estrogen bypassing liver metabolism.
Women, regardless of their political leanings, should consider the evidence and consult with their physicians, and then make personal decisions based on the evidence.
Dr. Makary is a prominent, educated and free thinking man. Gerald has lots of vague accusations and no data or research studies to support his article. Fortunately, people are beginning to demand facts before canceling others.
My doctor said that the 2002 study was done on women in their 60s and up, and that new studies have shown that HRT is safe and that new studies on HRT have shown positive results. My doctor said she’s on HRT, too.
Have there been recent studies that support that data?
Disappointing article. How can you write on this topic without ever mentioning the significant flaws of the WHI study, such as the average age of the participants when they started the therapy, as well as the fact that the hormones prescribed back then are fundamentally different from those prescribed today? That study simply does not apply to today's situation, and while we do need an updated RCT on the matter, we do indeed have good evidence of the benefits and low risks of TODAY's HRT, in women who initiate it at a younger age than those in the old study. Menopause is a natural process, but women were not meant to outlive it for as long as they do today.
Please educate yourself on the present state of research, talk to researchers and to gynecologists who care for menopausal women, and maybe even talk to some women whose quality of life has been rescued by HRT (anecdotal evidence no doubt, but the examples will abound). Dwelling on outdated research and rehashing generalities about Big Pharma's evils helps no one.
Hi Gerald, You may want to check in with women's health clinicians on this topic. The study that advised against hormone replacement therapy was poorly done and created a lot of issues for women who, for one reason or another, needed to have a hysterectomy. Physicians have been struggling to undo the damage done by that "study" since then.
It’s a good thing Gerald isn’t a doctor. What an idiot.
Yes, lots of confusing information out there. I was under the impression that HRT was okay once again--except for women with breast cancer, or a high risk for blood clots.
It's good to know the forces behind removing the black box warning.
Are there black box warnings for cross-sex hormone use? (Sometimes known as gender-affirming care, more like risky extreme body modification.)
Instead of reflexively condemning this decision because of the current administration— read and review the current literature and recommendations!!
The FDA’s update reflects evidence-based progress, not recklessness. This article by the Posners is poorly researched and misrepresents the decision to remove black-box warnings on hormone replacement therapy (HRT) for perimenopausal women. It relies on outdated interpretations of the Women’s Health Initiative (WHI) study.
Over the past decade, extensive parsing of the WHI data, published in JAMA, has clarified the timing of HRT.
If initiated before age 60 in women with intact estrogen receptors, HRT significantly reduces cardiovascular risk by up to 50 percent, lowers all-cause mortality, and, with estrogen alone, decreases breast cancer risk by 23 percent.
The ACOG, the Endocrine Society, and NAMS, now recommend individualized HRT for symptom relief and long-term health protection because of
benefits including 75-90% reduction in vasomotor symptoms, 50-60%
lower fracture risk, improved cognition, mood stabilization, and restored vaginal health.
There are of course risks which include minimal breast cancer increase with combined estrogen- progesterone therapy
with one additional case per 1,000 women annually,
and rare cases of venous thromboembolism which is reduced by transdermal estrogen bypassing liver metabolism.
Women, regardless of their political leanings, should consider the evidence and consult with their physicians, and then make personal decisions based on the evidence.
Dr. Makary is a prominent, educated and free thinking man. Gerald has lots of vague accusations and no data or research studies to support his article. Fortunately, people are beginning to demand facts before canceling others.
My doctor said that the 2002 study was done on women in their 60s and up, and that new studies have shown that HRT is safe and that new studies on HRT have shown positive results. My doctor said she’s on HRT, too.
Have there been recent studies that support that data?
You got this one 100% wrong. You need to check in with the actual science here.
Disappointing article. How can you write on this topic without ever mentioning the significant flaws of the WHI study, such as the average age of the participants when they started the therapy, as well as the fact that the hormones prescribed back then are fundamentally different from those prescribed today? That study simply does not apply to today's situation, and while we do need an updated RCT on the matter, we do indeed have good evidence of the benefits and low risks of TODAY's HRT, in women who initiate it at a younger age than those in the old study. Menopause is a natural process, but women were not meant to outlive it for as long as they do today.
Please educate yourself on the present state of research, talk to researchers and to gynecologists who care for menopausal women, and maybe even talk to some women whose quality of life has been rescued by HRT (anecdotal evidence no doubt, but the examples will abound). Dwelling on outdated research and rehashing generalities about Big Pharma's evils helps no one.