The Facts on the Women’s Health Initiative

Straight Talk from Dr. Alan Altman, MD

Alan Altman, MD*, clinical professor at Harvard Medical School and an advisor to Women in Balance, has assembled the real facts on the Women’s Health Initiative (WHI), a landmark women’s health study that when reported by the government had wide (and detrimental) impact – creating mass fear for women about hormones, and forever changing practitioners prescribing of hormones. 

Even though this study has had far reaching impact, less than one-third of women are even aware of the WHI, a recent study by Stanford researchers have found, and many doctors still are unaware of the real findings that have emerged over time and through critical analysis.

So, here are the facts on the WHI from an expert who understood from the beginning what the study showed and did not show.  

What the WHI (erroneously) “concluded." 

• Hormones are BAD for women
• Hormones increased breast cancer risk
• Hormones increased heart attack risk
• Hormones caused dementia
• Hormones should not be used for prevention of heart disease
• Only use hormones for symptom relief at the lowest dose and the shortest time (WIB note: currently there is no research on this recommendation)

What the WHI CAUSED after their “conclusion” 

• Primary Care Providers took their patients off all hormones
• Women stopped taking their hormones
• Media driven hysteria and panic among hormone users
• FDA change language from HRT to HT (hormone therapy)

WHI – Here are the Facts – Straight Talk from Alan Altman, MD 

• The WHI did not study all “hormones."  In fact, the ONLY hormones studied were Prempro© and Premarin© (non-human identical hormones and only pill form)

• The WHI Study was not really about “all women”…average age of the women studied were 12 years after menopause…averaged 64 years old at outset of study

• What WHI actually did show was that a 72-year old woman should not be started on oral Prempro© to protect her heart.

• Also, there appears to be a risk of breast cancer concerned with use of the potent synthetic progestin (or Medroxyprogesterone Acetate - MPA) that was used in the WHI.

• Oral estrogens increase the risk of blood clots and of strokes related to blood clots. (We’ve known this for 30+ years, however we see no increase in clots or strokes on non-oral estrogen.)

• Any small increase in dementia was seen only in women ages 75 to 80! (Numerous studies of women starting HT at the appropriate age close to their final menstrual period have demonstrated a 50% to 65% decrease in the risk of Alzheimer’s disease.)

• Women saw no quality of life benefits from taking these hormones, because 88% of the women in the study had no menopausal symptoms to begin with.

• There was a slight increase in breast cancer risk when on Prempro© (estrogen and progestin) and slight decrease on Premarin© (estrogen therapy).

Key Facts:

• Non-oral estrogen (specifically estradiol via transdermal patch, gel or transvaginal ring) AND natural micronized progesterone taken orally is presently safer, healthier and more “natural” for use in hormone therapy.

• There is a serious lack of consensus in the data looking at estrogen use and breast cancer risk.

• Testosterone can be useful in the appropriate patients post hysterectomy.

* Alan Altman, MD is Assistant Clinical Professor of OB/GYN and Reproductive Biology at Harvard Medical School.  He is a practicing gynecologist, specializing in peri and post-menopausal health, hormone replacement therapy and female sexuality. 

Op Ed says Initial Conclusions Drawn by the WHI Investigators were in Part Misleading. Calls on Government to Reissue Findings

The October 2007 issue of CLIMACTERIC, a professional medical journal, says detailed evaluation and analysis of the WHI data showed that the initial conclusions drawn by the WHI investigators were in part misleading. Read here >>

Source: WomenInBalance.org