Just going to clarify a point made about the WHI Study of HRT in post-menopausal women. The study did (relatively) conclusively (in a certain population of fem

Just going to clarify a point made about the WHI Study of HRT in post-menopausal women. The study did (relatively) conclusively (in a certain population of females with long term Rx) show that HRT can increase cardiovascular risk factors. This is useful information as women have lower CVD risks than men up to menopause (Framingham study showed reduced CV risk for women still cycling over those of same age with menopause) and it is thought that oestrogen was the protective factor, therefore giving HRT would be protective. The women studied were all post menopausal (many more than 1-2 years out) had varying risk factors for disease. I.e they had not just reached menopause, and thus represent a different population to that which would normally be prescribed HRT. Besides increased heart disease, stroke and VTE the study group also had reduced Colorectal cancer and Hip fractures that were statistically significant. Subsequent to this study, the KEEPS study (which may not have been published yet) randomised women to placebo, transdermal HRT and oral HRT, and which selected patients more appropriately as they were going through menopause, is showing no significant difference in CV outcomes or stroke, blood pressure or cancers between all groups. Another study, the DOPS study, a 10y follow up of 1000 Women over 50 on either HRT or placebo shows decreased CVD and no change in stroke or cancer risks. This study overturned the notion that for the general female population, HRT would exert various cardiovascular benefits. Nowadays it is established practice to only use HRT for severe symptoms of menopause (severe, lifestyle crimping hot flushes, mood changes etc) which in some women can last for many years. However treatment is meant to be reviewed regularly and tapered down.