Women’s Health Initiative: Good News and Bad News
by PJ Hennessy July 2002

This is NOT a reason to stop hormone usage but a reminder to clarify with your health professional WHY you are using them.

What: The Women’s Health Initiative (WHI) is seeking to define the risks and benefits of current strategies to reduce heart disease, fractures, breast and colon cancer.

Who: Between 1993 and 1998 the WHI enrolled over 160,000 women in the age range of 50-79 years of age (they are now 59-88 years of age).

How: The hormone trials (there are other nutritional and lifestyle trials) used:

1. Premarin alone (for women with a hysterectomy)
    
2. PremPro (premarin/provera combination: the most commonly prescribed menopausal remedy. In 2000, 46 million prescriptions for Premarin, the second most prescribed drug in America, accounted for over $1 billion in sales. PremPro equaled over 22 million prescriptions.) These were healthy, mostly post-menopausal women whose average age was 60. The Prem/Pro dosage was given without any prior hormone evaluation to individualize dosage, and was given regardless of weight/body composition or family history of breast or cardiovascular disease.
    
3. A placebo group.

Outcome: At 5.2 years of a planned 8 year study, the WHI Data Safety and Monitoring Board recommended the PremPro trial be stopped because risks exceeded benefits. Actual numbers per 10,000 women were: 7 more cardiac events, 8 more strokes, 8 more pulmonary emboli, 8 more invasive breast cancers, 6 fewer colon cancers, 5 fewer hip fractures. ADDED UP over 5 years, the excess negative effects were 100 events per 10,000 women, or 1/100 women.

Comments: While smaller studies have warned of this outcome since 1989, this study definitely disproves the conventional wisdom that Premarin protects hearts, when given with Provera (MPA or medroxyprogesterone acetate).

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