The results of two studies published in the early 21st century, the Women Health Initiative (WHI), and the Million Women Study (MWS), questioned the safety of HRT. The conclusions of both studies pointed to an increased risk of breast cancer and cardiovascular disease, with long-term use of HRT. This had a double effect: on the one hand, fear increased among the users (many abandoned the hormonal treatment), and, on the other, the international and national guidelines redefined the indications for use and the risks of HRT, which caused that many medical practitioners decided to suspend treatment equally.
However, new current evidence from sub-analyzes of the WHI study and long-term observational studies carried out with populations of postmenopausal women in different countries have questioned those excessively generalized conclusions, and have observed that there are groups of women where the risk of breast cancer and of cardiovascular diseases is less; specifically, those taking only estrogens or estrogens combined with dydrogesterone or micronized progesterone. In addition, the risk of both diseases was greatly reduced in those patients who started HRT within the first 10 years of menopause and in those who were less than 60 years old.
In short, today everything seems to indicate that the benefits of hormone replacement therapy in women who have recently started with a clinical picture due to menopause clearly outweigh the risks. Not only the relief of symptoms, but the prevention of the development of osteoporosis would justify its use from a clinical point of view. In any case, it will always be the gynecologist who decides when to prescribe HRT to a menopausal woman., with sufficient guarantees of efficacy and safety. But, the great reluctance caused by the publications of the WHI and MWS studies should be put aside and replaced by a more scientific and rational vision, in the light of new evidence, and for the sake of health.
/cloudfront-eu-central-1.images.arcpublishing.com/larazon/6ZNWZXOKZFEJZJNC5WY43BD7GM.jpg "Benefits and risks of hormonal treatment in menopausal women")
