* To HRT or Not to HRT?  So should women abandon HRT altogether?  "Hardly," say specialists like Steven R.  Goldstein, M.D., Professor of Obstetrics and Gynaecology at the New York Medical Center in Manhattan.  Instead, "every woman should revaluate exactly why she is on HRT to see whether the benefits still outweigh the risks," says Dr. Goldstein.  Thus, while medical research has finally provided some hard, fast answers, even the results of a landmark study cannot offer women a one-size-fits-all answer to the question of whether or not to take HRT.  *

1. The suggestion that the cardiovascular disease including stroke and blood clots and heart disease occured in some easily identifiable group of women - those who had existing risk factors for CVD is misleading.  The article and the comments of the researchers make very clear that the currently available data do not point to any particular group who were at higher risk of CVD as a result of prempro use.  This suggests that the risks were across the board, affecting all women regardless of individual risk, equally.  So the idea that a doctor can look at your history and tell you whether or not it would be safe for you, as an individual, to take prempro is not true.  It's a crapshoot whether the doctor tells you otherwise or not.

2. The rebound symptom phenomenon is not even mentioned.  The suggestion that menopause will continue while you take the pills and at some future date you will be "over" menopause as you might be "over" an illness, is not true for the majority of women.  We have many posting here whose experiences bear that out.  It may be that for some women delaying the symptoms for a couple of years is all they want.  That's a personal decision to make so long as the woman makes it with full information about the risks of the drug in those years that she's taking it, and that it is likely to be only a stopgap measure.

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1. The suggestion that the cardiovascular disease including stroke and blood clots and heart disease occured in some easily identifiable group of women - those who had existing risk factors for CVD is misleading.

2. The rebound symptom phenomenon is not even mentioned.  The suggestion that menopause will continue while you take the pills and at some future date you will be "over" menopause as you might be "over" an illness, is not true for the majority of women.

the writers and the commenting doctors need to take another look at the WHI findings; IMO, this new study trumps the old one, both in design and outcome.

Interesting that the ACOG's response to HERSII on July 3/02 was that this study didn't apply to healthy post menopausal women and that they would not change their recommendations until the WHI results were published.  Funny, when those were reported less than a week later, they still didn't change their recommendations even though the cardiovascular risk was higher in WHI than in any portion of HERS or HERSII.  The first year stats are horrifying with 43 heart attacks in the hormone group vs 23 in the placebo.  The difference goes down for the next three years (always with more in the hormone group, though) and then spikes again in the 5th year to 16 in the hormone group and 8 in the placebo group.

I think we've already seen how the drug company and the medical industry are going to spin this study.  "HRT" was never intended for longterm use and was/is seldom used longterm.  It was mostly prescribed for a year or two at 6 month intervals to women who had serious menopausal symptoms and who went to their doctors begging for something to relieve their awful menopausal symptoms.  Those doctors after informing their patients of the serious risks associated with these drugs prescribed the drugs for 6 month periods always cautioning women that they should try to get off the drugs every 6 months to see if they could now manage without them.  No doctor ever suggested to any woman that she should take these drugs for life to keep her young and moist and sexual and to protect her entire body from the ravages of estrogen deficiency.

What's that you say?  You don't remember it that way?  You remember relentless pressure to take the pills even if you never said a word about symptoms?  You remember the prescription pad being pulled out after you said "hot flash?"  And you remember being handed a drug company brochure explaining why you really needed these drugs for life?  You silly woman, your poor menopausal brain just isn't remembering things the way they really were.