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Dr. Sitruk-Ware shares if she agrees with the findings from the Women's Health Initiative (WHI) on hormone replacements.
Dr. Sitruk-Ware:
The Women’s Health Initiative was extraordinary undertaking, very large study which had the objective of determining whether a certain type of hormone therapy would prevent several kind of disease and replace the hormone missing in the body and still improving life of women.
Unfortunately, the study showed only negative outcomes. The reasons were that the population selected for the study was rather older than the menopausal women. When they come to the stage where they had their last menses and they had symptoms, and they need help. The Women’s Health Initiative had a population where the mean age was 63, and it’s not at that time that the woman starts to consult the physician.
In addition, there was only one kind of hormone which was the treatment selected in the study at a rather high dose for a population of age 65 and over, and because a large proportion of these women were in the study already with lesions in their arteries and disorders in their brain cells. These treatments, at a higher dose for them, have increased the risk. Unfortunately, the message that went was that all hormones for all women were bad, and this is wrong.
I think if the treatment is given during a good window of opportunity, which is during the ten years following the last menstrual period when the women really start to have symptoms, at an appropriate dose, respecting the contra indications, then the benefits are huge. And it can improve not only the bone protection but also decrease cardiovascular risk and improve brain function, and this was demonstrated in the younger age groups.
About Dr. Sitruk-Ware, M.D.:
Dr. Régine L. Sitruk-Ware is a reproductive endocrinologist and the executive director of research and development at the Population Council’s Center of Biomedical Research. She supervises the basic research in reproductive biology as well as the pre-clinical research and clinical development of new molecules designed for reproductive healthcare in men and women suitable for use in developing countries. Prior to joining the Council, she had a successful academic career in Paris, France and then an international career in research and development. She taught and conducted clinical research in reproductive endocrinology at the University of Paris for ten years. From 1983 to 1989 she was a member of the International Committee for Contraceptive Research (ICCR), established by the Population Council in 1970. RSW is now chairing the ICCR since January 2007. She is a member of several national and international medical societies. She has been a founding member of the International Menopause Society and a member of its Board for several terms and is presently the General Secretary of that society. She is also member of the Expert group on Hormonal Contraception of the European Society for Contraception. She is the Program Director and Principal Investigator of a NIH Center grant from the National Institute of Child Health and Human Development.
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