Hormone Replacement Therapy

"We want to make sure women know that long-term use of this combined [estrogen and progestin] hormone therapy may be harmful. The key is that women should talk with their doctor about how to ensure their continued good health."
Dr. Sharon Marble, Medical Director of the Rhode Island Department of Health's Office of Women's Health

On July 11, 2002, Patricia A. Nolan, Director of Health for the Rhode Island Department of Health, issued a statement regarding the premature ending of a major clinical trial involving Hormone Replacement Therapy of combined estrogen and progestin. The trial ended due to the conclusion that "harm [to the patient] was greater than the benefit [to the patient.]"

The clinical trial, a research study conducted in order to determine the effectiveness and side effects of combined estrogen and progestin hormone replacement therapy, was a component of the Women's Health Initiative, a program conducted by the National Institute of Health to investigate women's health issues. This particular clinical trial gave women with a uterus either estrogen plus progestin or a placebo treatment. After an average follow-up of 5.2 years, the study concluded that the estrogen plus progestin treatment increased a woman's risk of invasive breast cancer, coronary heart disease, stroke, and pulmonary embolism, compared to women receiving the placebo treatment. (A separate component of the Women's Health Initiative involves women without a uterus receiving either hormone replacement therapy of estrogen only or a placebo treatment. This second clinical trial continues, according to the RI Department of Health, because "the balance of risks and benefits of estrogen alone is still being considered.")

The Rhode Island Department of Health advises "Rhode Island women on the combined estrogen-progestin hormone replacement therapy (HRT) should make an appointment with their health care provider for further advice and follow-up."

(The Rhode Island Department of Health makes the following recommendations to women in Rhode Island:

• Regular physical exercise, good nutrition and smoking cessation reduce women's risk of heart disease, cancer and stroke.
  
• Routine self-examination and annual screening mammograms are very important for all older women but especially for women using hormone replacement therapy.
  
• Rhode Island women on the combined estrogen-progestin hormone replacement therapy (HRT) should make an appointment with their health care provider for further advice and follow-up.)

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