Our Review Summary
The New York Times provides vital context for this discussion of estrogen use after menopause. Kudos for the parsing of risk and including skepticism about the value of these results from outside researchers.
Why This Matters
Millions of women have already taken hormone replacement, and more are poised in the delicate transition where such therapy may be considered. The medical confusion is tricky for them, and this story will be widely read. Giving a true picture of this confusion is vital to helping women maneuver among unknowns.
Criteria
Not Satisfactory
The story does not touch on costs.
Not Satisfactory
Mixed bag here. The story does some of this, giving readers a “quantifier” example about how many of 10,000 women might forgo heart attacks due to taking estrogen, based on the study’s findings. But sadly, they don’t give a similar quantifier for the perhaps exaggerated headline: “Estrogen lowers breast cancer risk.” The same type of absolute risk calculation shows that the margin of benefit, if it exists, would be small: 8 fewer cases per 10,000 women per year. There may be a statistically significant difference, but it is small. Because of this omission, we judge this one unsatisfactory.
Satisfactory
Kudos to the The Times for parsing risk carefully. Among these: estrogen alone carries different risks than estrogen-with-progestin,
estrogen-alone for older women is much riskier than for younger women and risks for women who still have a uterus (unlike those who have had a hysterectomy) are also different. Last, but still important, the form of estrogen used in the study is not typically used now, so conclusions about benefits cannot be assumed to follow to the current form (estradiol.)
Satisfactory
Good job by the Times at digging below the surface and explaining nuance to readers. The critics, who published an editorial in the same JAMA issue point out that the WHI finding of decreased breast cancer risk with estrogen runs counter to results of many other studies showing an increased risk.
Satisfactory
The story does a good job of discussing a variety of risks without exaggerating any of them. If anything, they may exaggerate the benefits in the headline.
Satisfactory
The story benefits from direct interviews with sources holding different perspectives.
Satisfactory
The story delivered important information on how not all hormone replacement therapy is the same. For example:
“A major caveat in interpreting the new estrogen data is that the study used conjugated equine estrogens, which are estrogen compounds derived from the urine of pregnant mares and marketed by Wyeth Pharmaceuticals under the brand Premarin. The brand has fallen out of favor with many women who are choosing treatments that contain estradiol, which is chemically similar to a woman’s natural estrogen. It is not known whether the benefits of estrogen shown in the Women’s Health Initiative would be replicated using a different type of estrogen.”
and
”
Dr. Chlebowski previously led research that showed cancer risks associated with combination hormone therapy, but he says the new data on estrogen alone show that in certain women, estrogen use to relieve menopausal symptoms is a “good choice.”
“When you look at the debate, people are saying hormones are good or not good — it’s been all or nothing. This calls attention to the fact that there are differences,” said Dr. Chlebowski. “I hope that separation will become clearer now.”
Not Applicable
Estrogen is widely available and story does not need to talk about that.
Satisfactory
The story doesn’t make any inappropriate claims about estrogen, and it does appropriately try to frame the novelty of the research – “a finding that challenges the conventional wisdom about the risks of some hormones used in menopause.”
Satisfactory
The story includes independent reporting, so it’s clear it didn’t rely on a news release.
Total Score: 7 of 9 Satisfactory
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like