Dramatic Drop in Hormone Therapy Use
Results of Clinical Trial Convince Many Women to Abandon Hormone Therapy After Menopause
"We are beginning to see a backlash against the backlash," North American Menopause Society president Wulf H. Utian, MD, PhD, tells WebMD. "When the news hit, women got the message that all hormone therapy was bad. Now the pendulum is beginning to swing back toward the middle."
Government health guidelines now call for hormone therapy to be used only for the management of menopausal symptoms, like hot flashes and vaginal dryness, and in the lowest effective dosage for the shortest possible time. Prempro and Premarin manufacturer Wyeth Pharmaceuticals has introduced low-dose versions of both drugs. The company is aggressively marketing the low-dose preparations as alternatives to traditional hormone therapy.
"Women who need hormone therapy are going back to it, but they are also having very educated discussions with their health-care providers about the risks vs. benefits," Utian says.
Public Debate Drives Policy
Stafford says the dramatic decline in hormone therapy in menopausal women, in the wake of news reports following the WHI announcement, show that the health-care system can respond quickly to clinical trial results under the right circumstances.
In the same issue of JAMA, the researchers reported a smaller, but still significant, decline in the use of a class of hypertension drugs known as alpha-blockers after they were linked to an increased risk of heart failure. Both stories received significant media attention.
"A main message from these two experiences is that sometimes for clinical trial results to really have an impact, they need to leave the professional arena and become part of the public consciousness and conversation," Stafford says. "This is an idea that scientists are often uncomfortable with. But we have to recognize that there are social forces that are very important for determining whether clinical trial results really make a difference."