If one filters out the frequent references to thyroid extract which seems to have been viewed as a cureall for the climacteric - much as estrogen later became -  the text below describes symptoms and situations which are very familiar to anyone knowledgeable about perimenopause. Of prime interest is the fact that they are attributed to both sexes, rather than being at worst the fault of the female, at best hers alone to suffer. The recommendations for dealing with them may be over sixty years old but they are still well worth considering - even the thyroid testing.

more history

Since the HERS results were published, many physicians have clutched at every hint that HRT might have benefit in preventing disease, death, and long-term disability in postmenopausal women.  More evidence brings more pessimism about the preventive benefits of HRT and ERT.  What then remains?
<major snip>
Pessimism about HRT and ERT does not mean pessimism about disease prevention in postmenopausal women.  Randomized trials that included women provide strong support for the use of [see article]

http://jama.ama-assn.org/issues/v288n1/abs/joc20521.html 
Cardiovascular Disease Outcomes During 6.8 Years of Hormone Therapy Heart and Estrogen/Progestin Replacement Study Follow-up (HERS II)
Conclusions 

Lower rates of CHD events among women in the hormone group in the final years of HERS did not persist during additional years of follow-up.  After 6.8 years, hormone therapy did not reduce risk of cardiovascular events in women with CHD.  Postmenopausal hormone therapy should not be used to reduce risk for CHD events in women with CHD.

http://jama.ama-assn.org/issues/v288n1/abs/joc20522.html
Cardiovascular Disease Outcomes During 6.8 Years of Hormone Therapy:Heart and Estrogen/Progestin Replacement Study Follow-up (HERS II)
Conclusions 

Treatment for 6.8 years with estrogen plus progestin in older women with coronary disease increased the rates of venous thromboembolism and biliary tract surgery.  Trends in other disease outcomes were not favorable and should be assessed in larger trials and in broader populations.

Finally, given the associations of emotional symptoms with high estradiol levels, it is not surprising that cycling perimenopausal women whose estrogen levels are at least intermittently extremely high would experience unwanted emotional symptoms.

Hormone Replacement Therapy Falls Out of Favor With Expert Committee

[Introduction only]

Bethesda, Md Falling in line with the evidence-based medicine trend, an international team of women's health experts is discouraging the use of hormone replacement therapy (HRT) for many postmenopausal conditions. Coronary heart disease, fractures, depression, urinary incontinenceall cited in the past as prime reasons to initiate HRTare losing favor as valid indications for it, as evidence from high-quality clinical trials accumulates.

For years, it was a medical truism that the earlier cancer could be detected, the better.  Most cancers would inevitably worsen if left untreated, the theory went.  Spontaneous remissions were so rare as to be almost unheard of.

But last week, those assumptions were shattered, at least in the case of a childhood cancer.  A screening test that looked as if it would save children from terrible deaths from a cancer of the nervous system utterly failed to fulfill its promise.

Now the story of that screening and questions about tests for adult cancers like mammography and a blood test for prostate cancer are ushering in a broader debate about cancer screening in general ..........

Benefits of screening mammography

Some research has doubted the benefit of screening mammography.  But new data now show that there may be a modest benefit for women aged 55 years or over........ they found a significant 21% reduction in breast cancer mortality for women given screening mammography.  But the benefit was less apparent in women aged 50-54 years.......

Raloxifene and Cardiovascular Events in Osteoporotic Postmenopausal Women
Four-Year Results From the MORE (Multiple Outcomes of Raloxifene Evaluation) Randomized Trial
Elizabeth Barrett-Connor, MD; Deborah Grady, MD; Andreas Sashegyi, PhD; Pamela W. Anderson, MD; David A.  Cox, PhD; Krzysztof Hoszowski, MD; Pentti Rautaharju, MD; Kristine D.  Harper, MD; for the MORE Investigators

Extract from
Discussion

In summary, there was no evidence that raloxifene caused an early increase in risk of CV events, either overall or among postmenopausal women at high risk for or with CHD.  Raloxifene therapy for 4 years did not significantly affect the overall risk of CV events in the total MORE cohort but did significantly reduce the risk of CV events among women at high risk for and among those with established CHD.  Before raloxifene is used for prevention of CV events, these findings must be confirmed by an adequately powered, randomized trial with CV events as predefined outcomes.

Unusually, early press releases on the study tended to be conservative and usually included reference to the study authors' cautions on interpretation, and though headlines focussed on the positive results they did incude the word "may" or "might". For example:

http://story.news.yahoo.com/news?tmpl=story&u=/nm/20020219/hl_nm/evista_heart_1
Raloxifene May Protect Hearts of High-Risk Women (Reuters)

http://story.news.yahoo.com/news?tmpl=story&u=/ap/20020219/ap_on_he_me/osteoporosis_drug_heart_2
Study: Drug May Lower Heart Risks (Associated Press)

related material

more history
soapbox archives

Objective: 

To determine whether the association between HRT and risk of breast cancer varies by HRT formulation and differs across histologic cancer types.

CHICAGO (Reuters) - 

The suspected breast cancer risk associated with post-menopausal hormone replacement therapy may involve a type of tumor that can be hard to detect, researchers reported on Tuesday............If there really is an increased risk for lobular breast cancer, it added, that "could have implications for screening, because lobular carcinomas are relatively more difficult to palpate (feel) and more difficult to diagnose by mammography......

http://www.usatoday.com/news/healthscience/health/women/2002-02-06-hormone-therapy.htm
Hormone therapy can lower energy levels
By Rita Rubin, USA TODAY

Postmenopausal women who aren't having hot flashes may feel worse physically if they start taking hormones, says a study out Wednesday.

............The women in the study had heart disease and their average age was 67, so the findings may not apply to healthy younger women who take hormones around the the time of menopause.  Nevertheless, researchers called the results surprising and said they cast doubt on the popular belief, encouraged by drug advertisements, that taking hormones after menopause can make most women feel more youthful, active and vibrant............

Although estrogen is approved to treat hot flashes and vaginal dryness and to prevent osteoporosis (bone-thinning), Chevy Chase gynecologist James Powers said the makers of hormone products commonly suggest in magazine advertisements that the drugs improve energy, mood and vitality.

"Even our own medical journals are laden with pictures of lovely, attractive women engaged in hard physical activity, as an example of how you can look and feel if you take their product," he said.

---

Unfortunately, many in the media have misrepresented the data, extrapolating the results of this study to all women, with inflammatory headlines such as, ``Treatment may not lessen effects of menopause'' and ``HRT benefits questioned.'' The published HERS data do nothing to resolve the issue of the effects on HRT on QOL of all women.

`We at NAMS are deeply disturbed that a paper with such highly questionable methodology would even have been published,'' commented Dr. Utian.  ``For the media to take that data and make a general statement that hormone replacement therapy does not improve the quality of life for all women is unconscionable.''

Extract from Lancet Volume 359, Number 9304 02 February 2002
Screening mammography: setting the record straight

Sir--Reviews of randomised screening trials done earlier than that undertaken by Ole Olsen and Peter Gøtzsche (Oct 20, p 1340)1 have supported the practice of screening for breast cancer with mammography, particularly for women older than 50 years;2,3 Olsen and Gøtzsche challenge this view.  Unfortunately, they provided one version of their review to The Cochrane Library4 and another (which is not an approved Cochrane review) to The Lancet.1 These two reviews, although similar, differ in some important features that may lead to confusion.

In his Oct 20 commentary,5 Richard Horton claims the Cochrane Breast Cancer Group (CBCG) attempted to unduly influence the text of Olsen and Gøtzsche's review in The Cochrane Library.  Since Olsen and Gøtzsche conclude that screening mammography is not justified, Horton implies that we tried to suppress this information, which is not the case.

Wednesday February 6, 4:08 pm Eastern Time Press Release SOURCE: Cancer Prevention Coalition
Extract from Mammography Is Dangerous Besides Ineffective, Warns Samuel S. Epstein, M.D. 

CHICAGO, Feb. 6 /PRNewswire/ -- The following was released by Samuel S.. Epstein, M.D., Chairman of the Cancer Prevention Coalition and Professor Emeritus of Environmental and Occupational Medicine, University of Illinois School of Public Health, Chicago:

Recent confirmation by Danish researchers of longstanding evidence on the ineffectiveness of screening mammography has been greeted by extensive nationwide headlines.  Entirely missing from this coverage, however, has been any reference to the [following] well-documented dangers of mammography.

---

Putting Mammograms to the Test 
By GINA KOLATA

In what is considered the gold standard of scientific evidence gathering, a randomized controlled clinical trial, some people are having the potentially lifesaving screening tests, and some are not.  An independent monitoring committee is standing by to see if the cancer death rate in one group exceeds that in the other.  At that point, the study will end.

But when it comes to mammograms, even Dr. Kramer gives up......

Dr. Kramer said: "I never like to say it's impossible.  But in the U.S. it would be very, very difficult" to do a new randomized mammography trial.

Health & Medicine 1/21/02 
Hormones on trial Medical wisdom about menopause therapy is coming under question
BY AMANDA SPAKE

........like many of the 8 million to 16 million women over age 50 in the United States who are taking postmenopausal hormones, Chasin is having second thoughts.  Subsequent studies have made the issue of health benefits and risks a lot murkier than it originally appeared........

Increasing numbers of women in their 50s and 60s are using hormone replacement therapy to alleviate menopausal symptoms.  The effect of long term use of these agents in women aged over 50 on the breast is only now becoming apparent.  Hormone replacement therapy given to perimenopausal women increases breast pain and nodularity, increases the frequency of benign cysts and fibroadenomas in the breast, and results in the growth of some already established benign lesions.
<snip>
The evidence that hormone replacement therapy reduces the effectiveness of breast screening and causes breast cancer in women over the age of 50 is clear; the challenge for clinicians is to control menopausal symptoms while limiting these unwanted effects.

Two weeks later, the Washington Post followed up with an article doubting its efficacy:
From http://www.washingtonpost.com/wp-dyn/articles/A22926-2001Dec10.html 
 A Poor Barometer for 'the Change'? by Sally Squires

"I am surprised that the FDA approved this test," said Wolf Utian, professor emeritus of obstetrics and gynecology at Case Western Reserve University Medical School in Cleveland.  "I cannot think of a reason why a woman should be doing a test like this."

http://www.the-scientist.com/yr2001/oct/research3_011015.html
The Scientist 15[20]:21, Oct. 15, 2001

Estrogen Replacement and Cognition: Ready for Prime Time?
Definitive answers about ERT effects are down the road.
By Harvey Black

While estrogen replacement therapy shows promise in helping post-menopausal women preserve important cognitive abilities such as memory, its effectiveness is still being questioned. <snip>.....

......."It will take us some, probably a few more years to tease it out.  But as a researcher I believe there are niches for estrogen.  We just haven't hit on them," she says. 

Considerable mystery surrounds acupuncture. The procedure arose in traditional Chinese medicine, which also involves the use of herbs, massage, meditation, and diet. For two views on the origins of this ancient technique, see Acupuncture: A History and The History of Acupuncture. Despite its longevity, however, the medical use of acupuncture remains controversial, at least in the West.
<snip>
.......Once thought to be the province of the counterculture, acupuncture now holds wide public acceptance as a complement to mainstream therapies. .......

Daily oral estrogen plus progestin therapy was associated with worsening urinary incontinence in older postmenopausal women with weekly incontinence. We do not recommend this therapy for the treatment of incontinence.

http://cvm.controlled-trials.com/content/2/5/211
Do we need clinical trials to test the ability of transdermal HRT to prevent coronary heart disease? 
David Crook Department of Cardiovascular Biochemistry, St Bartholomew's and the Royal London School of Dentistry and Medicine, London, UK.
Curr Control Trials Cardiovasc Med 2001, 2 : 211-214

Conclusion:

The severe mismatch between observed and expected results for oral HRT in randomized controlled trials of CHD end-points challenges the validity of observational epidemiology, animal studies, and traditional CHD [coronary heart disease] surrogates......

These data suggest that women who use HRT, particularly estrogen alone, are at increased risk of dry eye syndrome. Physicians caring for women who are taking or considering HRT should be apprised of this potential complication.

"There is no reliable evidence that screening for breast cancer reduces mortality."  This conclusion, published in The Lancet this week, confirms previous controversial analysis from researchers in Denmark.

---

http://www.bmj.com/cgi/content/full/323/7319/956(British Medical Journal)
BMJ 2001;323:956 ( 27 October )
Row over breast cancer screening shows that scientists bring "some subjectivity into their work
Susan Mayor, London

The difficulty of getting scientists to reach a consensus on their interpretations of trial data was illustrated last week when two reviewers for the Cochrane Breast Cancer Group published their own review of mammography screening trials after editors from the group had disagreed with some of their conclusions. <snip>

http://www.abc.net.au/science/news/stories/s394891.htm(Australian public radio)
Debate over evidence for breast screening Monday, 22 October 2001

A dispute over breast cancer screening has brought into the spotlight international power plays over the interpretation of medical evidence.

"There is an urgency for the data to be re-analysed correctly," says breast-cancer clinician Serge Rozenberg of the Free University of Brussels in Belgium, and for women to be informed of existing doubts over the efficacy of screening.  "This is about millions of women," he says; not acting on this study is "unacceptable".

But some still dispute Olsen and Gotzsche's techniques and findings.  "We estimate that screening is saving on average 1,250 lives a year," says Julietta Patnick, National Coordinator of the UK's National Health Service breast-screening programme, which aims to examine all women over 50 every 3 years.

Bone densitometry is widely used in osteoporosis clinics to identify people at increased risk of fracture.  Terence Wilkin and Devasenan Devendra believe that evidence for the efficacy of bone densitometry is weak, but Jan Dequeker and Frank P Luyten argue that their interpretation of the evidence is too narrow and that screening high risk patients is cost effective

  NEW YORK (Reuters Health) -  According to the report in the September issue of the American Journal of Obstetrics and Gynecology (news - web sites), there is a lack of consensus among obstetricians and gynecologists on how to manage women who are told they have two particular abnormalities in their Pap test results. The test allows physicians to look for changes in cervical cells that may signal cancer and is considered the best way to screen for cervical cancer. <snip>

    ``Compared with published guidelines, practitioners undermanage patients with AGUS and overmanage patients with ASCUS,'' Dr. Karen Smith-McCune from the University of California, San Francisco, and her co-authors conclude. ``These results are of particular concern, given the much higher rates of significant disease in patients with AGUS compared with ASCUS.''

  The researchers recommend that future studies investigate why doctors choose to manage these conditions in different ways and that more aggressive educational efforts be made to streamline treatment decisions.

--Got kidney stones? Don't drink soy milk or eat tofu, soy energy bars or just about anything else containing the otherwise healthful soybean. New research shows soy-based products could increase the risk of developing this painful urinary tract condition.
<snip>
Massey's discovery about soy products also may be significant for women just before menopause, when the risk of vulvar pain increases and when many women turn to soy-based products for hormonal support.

  "We plan to study isoflavones, a component of soy often found in many menopause-related products, to check oxalate levels here as well," says Massey. 

from
http://womenshealth.medscape.com/Manisses/GPU/2001/v05.n09/gpu0509.01/gpu0509.01.html#1
Can Sex Hormones Protect Against or Treat Alzheimer's?
[Brown Univ Geriatric Psychopharm Update 5(9):1-3, 2001. © 2001 Manisses Communications Group, Inc.]

During the last ten years, a significant number of studies have been conducted that explore the possibility of a connection between sex hormones and dementia.

In spite of numerous clinical trials, definitive findings that support or question the role of estrogen in preventing, delaying onset or diminishing symptoms of Alzheimer's disease have not been reached. 

Estrogen: Hope or Hype?

The sex difference in mortality from coronary heart disease varies over time and between countries in a way that cannot be explained by endogenous oestrogen 

These trends indicate that sex differences in mortality from coronary heart disease are driven primarily by environmental factors 

Sex differences in coronary heart disease are not inevitable 

 Birth Control Pill, Urine Protein Link
http://dailynews.yahoo.com/h/ap/20010909/hl/hormones_heart_1.html

CHICAGO (AP) - Dutch research links birth control pills and menopause hormone supplements with small amounts of protein in the urine that may signal an increased risk of kidney and heart disease. 

 Women who used either of the estrogen-based pills faced about double the risk of developing the urine protein condition, called microalbuminuria, compared with nonusers. 
<snip>

Doctors not involved in the research stressed that the study is preliminary. 

``These are provocative findings but they clearly need confirmation,'' said Dr. JoAnn Manson, chief of preventive medicine at Harvard University's Brigham and Women's Hospital. ``It certainly doesn't prove cause and effect."

http://www.medscape.com/reuters/prof/2001/09/09.03/20010831epid004.html
Hormone Replacement Therapy Tied to Lower Mortality From Breast Cancer 

WESTPORT, CT (Reuters Health) Aug 31 - Women who use hormone replacement therapy (HRT) are less likely to die from breast cancer than nonusers, according to the results of a meta-analysis conducted by researchers at the University of Maryland School of Medicine in Baltimore. 
<snip>

However, Dr. Eugenia Calle, director of analytic epidemiology at the American Cancer Society in Atlanta, disagrees with some of the conclusions drawn by Dr. Flaws' group. She referred to a 1997 Lancet report by the Collaborative Group on Hormonal factors in Breast Cancer <snip> [which] "established a definite association between HRT and recent and current use of HRT of long duration. I don't think that issue is open to debate anymore," she added. 

"Most of a few studies have shown slightly better survival in women treated with HRT. Is it real? I don't know," she said. "It is an important question that remains to be resolved through further epidemiological study." 

item #1: HRT is not recommended for routine use in the menopause.

WASHINGTON (Reuters) - Doctors should not prescribe hormone repplacement drugs to post-menopausal women with the single purpose of trying to ward off heart attack or stroke, the American Heart Association (news - web sites) said on Monday.

http://www.washingtonpost.com/wp-dyn/articles/A40821-2001Jul23.html
which also contains the previously unpublicised information that

Last month, researchers running the WHI informed study participants that they continue to see a small increase in the number of heart attacks, strokes and blood clots in women taking hormones, compared with nonusers. Although fewer than one-half of 1 percent of hormone users have suffered such illnesses each year, the trend has persisted for three years. The study's data safety monitoring board, which periodically reviews safety data, voted unanimously to continue the trial. 

Women who are concerned about their hearts should place much more emphasis on strategies that are known to help, such as watching one's diet and weight, avoiding smoking, and (when appropriate) taking medications that lower cholesterol levels or blood pressure, the heart association said. Suchstrategies are seriously underutilized, said Dr. Lori Mosca, lead author of the new guidelines and director of preventive cardiology at New York Presbyterian Hospital.

The first report was developed from analysis of data from 2489 postmenopausal women in the oft-used Nurses' Health Study of women. Each had had a heart attack or was known to have atherosclerosis. 

Extract from Short-Term Hormone Use Tied to Increased Risk of Recurrent Coronary Events
WESTPORT, CT (Reuters Health) Jul 02 -

Using postmenopausal hormones for less than a year seems to increase a woman's risk of recurrent major coronary events, but the risk decreases with increasing duration of use. 

.........Compared with women who had never used hormones, women who had used hormones for less than a year had a relative risk of 1.25 for a major coronary event.. After the 1-year mark, however, the relative risk decreased to 0.38. 

Extract from
Starting Hormone Replacement Therapy After MI Linked to Higher Cardiac Event Rate

WESTPORT, CT (Reuters Health) Jul 02 - Postmenopausal women who start hormone replacement therapy (HRT) soon after a myocardial infarction (MI) appear to be at increased risk of cardiac events, researchers report in the July issue of the Journal of the American College of Cardiology. 

............After adjustments, new HRT users still had a significantly higher risk of death, MI or unstable angina compared with never-users of HRT (relative risk 1.44). Dr. Alexander's group notes that there was no increased risk of coronary events among women who were prior or current users of HRT. 

Hormones Risky for Women with Heart Disease
NEW YORK (Reuters Health) - July 2

Although hormone replacement therapy (HRT) has been thought to  protect women's hearts after menopause, two new studies confirm that for women with heart disease, HRT can temporarily raise the risk of heart attack and death.

 An earlier trial called the Heart and Estrogen/progestin Replacement Study had shown that among  women with heart disease, taking oral estrogen plus progestin elevated the risk of recurrent heart  problems in the first year of use, then lowered it thereafter.

.........And there was no apparent difference based on type of HRT, according to Dr. Francine Grodstein and  her colleagues at Harvard University in Boston, Massachusetts. More than half of the women on HRT were taking oral estrogen alone, while 19% were on oral estrogen plus progestin. The rest used other HRT regimens such as the estrogen patch.

To date, 2 large randomized controlled trials, a quasi-randomized trial, a large cohort study and several case-control studies have failed to show a benefit for regular performance of BSE or BSE education, compared with no BSE. In contrast, there is good evidence of harm from BSE instruction, including significant increases in the number of physician visits for the evaluation of benign breast lesions and significantly higher rates of benign biopsy results. 

.....In summary, we agree with the task force that there is still not much evidence BSE helps and that there is more evidence it can harm. Is it time, therefore, to tell patients that BSE should not be practised? 
<snip>

Meanwhile, clinicians have much stronger evidence for mammography and well-done clinical breast examination, and we should emphasize  these screening methods with our patients. For BSE, we must honestly share the uncertainties about its potential benefits and harms and then help patients in their decisions about its use.

When my doctor glanced at my age - 49 years - and said it was time to get me started on my HRT, I was shocked! I had been living out of the United States and was not subjected to the youth obsession.

The author, Katherine J Zamecki, writes:

...I think this study is relevant to all women because it pertains to the construction and control of the female body, the increasing growth of medical hegemony, and the significance of listening to and learning from women. It is only by sharing experiences across age and regardless of race or class, that women can assert the significance of their personal narratives and possibly lead the way to a future of change. 

*hegemony: preponderant influence or authority of one individual or social group over another. 

Conclusions: Elderly women with high BMD have an increased risk of breast cancer, especially advanced cancer, compared with women with low BMD

Apparently, though, the latest research about HRT's effects has not trickled down to many doctors who care for postmenopausal women, nor, as a result, to the women themselves.

Not that good apparently.... The article includes the statements:

....This meta-analysis highlights the fact that evidence about the efficacy of postmenopausal estrogen for prevention of osteoporotic fractures is weak.
and
.....Since women in their 50s who do not have osteoporosis have a relatively low risk of fracture, the benefit of long-term treatment with estrogen to prevent bone loss and fractures may not exceed the risks.
related material

" ...lead author Dr. Holly L. Howe told Reuters Health. ' We think this is associated with increased mammography screening in this population. In such cases we often see an increase in incidence but eventually a decline in mortality.' "

Further commentary on this report can be found at http://www.washingtonpost.com/wp-dyn/health/latestap/A27141-2001Jun6.html

No mention was made in either case of the increase in breast cancer risk from HRT use 
related material

Increased incidence of small and well-differentiated breast tumours in post-menopausal women following hormone-replacement therapy

Incidence of breast cancer was increased in post-menopausal women who used HRT at baseline. Among HRT users, there was over-representation of tumours that, with regard to stage, type and grade, are associated with a favourable prognosis.

However; an item at http://www.uptodate.com/patient_info/topicpages/text/8599O5.asp which discusses different forms of estrogen administration does not recommend the use of such sprays - see the URL for the reasons.

related material

1927 - Casting ouut Fear. "We, therefore, find that the female, notwithstanding her greater affectibility by minor stimulus, more youthful, more resistant to adverse influences, and longer lived than the male." 

1939 - The menopause in women (Climacteric) "We frequently note a condition of severe insanity (paranoia) or melancholy. These are the so-called climacteric psychoses, usually incurable...."
more history

1) a 1963 article aiming to fully inform women considering hormone replacement, which is reasonable and upfront despite erors of fact.
IS THE MENOPAUSE A NORMAL CHANGE OR IS IT A DISEASE NEEDING TREATMENT?
A TEACHING DEVICE TO ASSIST ACTIVE THERAPEUTIC INTERVENTION IN THE MENOPAUSE 

2) an already published article quoted in 1965 which is scaremongering and filled with lurid language. This foreshadows the style of Feminine Forever (below)
 ESTROGEN THERAPY FOR POSTMENOPAUSAL FEMALES

more history

http://jama.ama-assn.org/issues/current/abs/joc01947.html
Women who used postmenopausal estrogens for ten years or more were at substantially increased risk of fatal ovarian cancer that persisted for many years after estrogen replacement therapy was stopped

http://jama.ama-assn.org/issues/current/abs/joc01926.html
A longer reproductive period, thought to be related to a longer exposure to estrogen produced within a woman's body, does not appear to reduce a woman's risk of dementia and Alzheimer disease.
related material

......In summary, our findings indicate that ERT use in postmenopausal  women is not associated with a substantially reduced risk of AD, and highlight the need for restraint in advocating postmenopausal ERT for this purpose.
related material

http://bmj.com/cgi/content/full/322/7285/510
Vaccine against cervical cancer virus passes phase 1 trials
Women may soon be able to take a vaccine to protect themselves against cervical cancer, one of the most common malignancies to affect women.
related material

WASHINGTON (AP) - While stressing the value of estrogen treatments for women, a government scientific advisory panel recommended Friday that the chemical be added to the nation's list of cancer-causing agents. Maybe, one scientist said, this step might encourage doctors to talk with their patients about both the risks and the benefits. 

 ``Physicians never discuss any of these risks when they are prescribing  hormone therapy,'' Michelle Medinsky, a toxicologist from Durham, N.C.,  told the National Toxicology Program advisory committee. ``They only discuss benefits. Listing might force it on the table.'' Medinsky said.
related material

Another article (from the journal Pharmacotherapy) reaching the same conclusion can be found at http://www.medscape.com/PP/Pharmacotherapy/2000/v20.n09/pharm2009.01.barb/pharm2009.01.barb-01.htm
It includes a link to the revised HERS tables - which do not change the original conclusion but give more detail than I remember seeing before - at  http://www.keeptrack.ucsf.edu/hers2/HERSfindat.htm. 
related material

AMSTERDAM, Sep 05 (Reuters Health) - British researchers reported here during the XXII annual congress of the European Society of Cardiology that transdermal hormone replacement therapy (HRT) does not reduce the risk of cardiac events in postmenopausal women with existing coronary artery disease (CAD).
related material

           A new study finds that estrogen replacement therapy, which doctors have long hoped will prevent heart disease in postmenopausal women, does nothing to slow the disease's progression in those whose arteries have already been partly blocked by it.

          The study is being reportedin today's [Aug 24, 2000] issue of The New England Journal of Medicine.
related material