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    Hormone Therapy: For Whom? How Long?

    When Is Menopausal Hormone Therapy Appropriate? Expert Panel Weighs In

    Finding the Bottom Line

    But what, exactly does this mean for specific groups of women? To try to get consensus, Ettinger worked with a panel of eight other experts. The panel started by concluding that the only menopausal women who need hormone therapy are those whose lives are disrupted by severe hot flasheshot flashes.

    The panel then found that, in specific circumstances, hormone therapy was acceptable, unacceptable, or uncertain. Uncertain means that most panelists had "midlevel enthusiasm for hormone therapy in a particular setting."

    For women with a uterus, the panel found that:

    • Oral, standard-dose hormone therapy is appropriate only for women with normal risk of heart diseaseheart disease and normal risk of blood clots. It is uncertain for women at elevated risk of heart disease but normal risk of blood clots.
    • Oral, low-dose hormone therapy is appropriate only for women with normal risk of heart disease and normal risk of blood clots. It is uncertain for women with either elevated risk of blood clots or elevated risk of heart disease, but not both.
    • Transdermal hormone therapy is appropriate for women with normal or elevated risk of heart disease and normal risk of blood clots. It is uncertain for women with elevated risk of blood clots and both normal or elevated risk of heart disease. It is also uncertain for women with normal risk of blood clots who have had a strokestroke or transient ischemic attack (TIA)transient ischemic attack (TIA).
    • For all other combinations of heart disease/blood clot risk or stroke/TIA history, hormone therapy is inappropriate.

    For women without a uterus -- that is, women who have had a hysterectomy -- the panel found that:

    • Oral, standard-dose hormone therapy is appropriate only for women with normal risk of heart disease and normal risk of blood clots. It is uncertain for women with normal blood clot risk and elevated risk of heart disease.
    • Oral, low-dose hormone therapy is appropriate only for women with normal risk of heart disease and blood clots. It is uncertain for women with either one of these risks alone, but not both together.
    • Transdermal hormone therapy is appropriate for women with normal heart disease/blood clot risk and for women with only one of these risks. It is uncertain for women with elevated risk of both heart disease and blood clots.
    • For all other combinations of heart disease/blood clot risk or stroke/TIA history, hormone therapy is inappropriate.

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