After 7 years of follow up, the estrogen alone arm of the WHI study was stopped. The preliminary conclusion is that estrogen only replacement offers no additional benefits to women in terms of cardiovascular protection, increases the risk of stroke, decreases hip fractures and no increase in breast cancer. This follows the halting of the estrogen plus progestin replacement arm in 2002, when the risk of stroke , heart disease and breast cancer was increased in patients taking the estrogen plus progestin pills.

So the current recomendations to physicians are that Hormonal replacement should not be given to women for cardiovascular protection.

Current Labeling: Indications and Usage

1. Treatment of moderate to severe vasomotor symptoms associated with the menopause.

2. Treatment of moderate to severe symptoms of vulvar and vaginal atrophy associated with the menopause. When prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy, topical vaginal products should be considered.

3. Prevention of postmenopausal osteoporosis. When prescribing solely for the prevention of postmenopausal osteoporosis, therapy should only be considered for women at significant risk of osteoporosis and non-estrogen medications should be carefully considered.

So the era of glory for hormonal replacement therapy has really ended. It was once widely prescribed to postmenopausal women and touted as a wonder drug for menopausal women. Now it appears that less and less physicians will be using it. What's next?

Women's Health Initiative
National Heart Lung and Blood Institute -WHI