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Hormone replacement therapy regains popularity

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1 Star

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Hormone replacement therapy regains popularity

Our Review Summary

This article is one-sided in claims about the benefits of hormone replacement therapy (HRT) while dismissing current evidence and quoting only doctors who are advocates about using HRT.  The article demonstrates examples of disease mongering language and lacks any quotes from doctors who disagree with the two doctors quoted – quotes/doctors that wouldn’t be difficult to find.

It also contains several inaccuracies:

  • It said the conclusions of the Women’s Health Initiative (WHI) study “have been discredited by subsequent studies.” Really?  Discredited?  By which studies?
  • It said “Many women in the Women’s Health Initiative study were well past menopause, were obese or were smokers and therefore already at risk of heart disease and stroke.”  This is misleading. Since it was a randomized clinical trial, obesity and smoking were equally represented in the placebo/control groups.
  • Inaccuracies in physician quotes that should have been corrected:
    • The WHI didn’t “help us learn” anything about other forms of therapy since it did not study them.  Other studies have, but not WHI.
    • Another awkward quote suggested estrogen therapy for vaginal prolapse – which is an anatomic problem not effectively treated by HRT.

 

 

Why This Matters

The Women’s Health Initiative (WHI) was not designed to study HRT in women with menopausal symptoms, but, rather, to see if HRT had benefits – mainly for reducing risk of heart disease as a preventive approach for all menopausal women.  The finding of increased cardiovascular risk was the big news of the WHI.  However, later analyses of the same data, looking at younger menopausal women, have shown that heart risks do not apply to this subset of women.

Although some women may benefit from using HRT, these benefits should be framed with appropriate evidence from peer-reviewed sources and any discussion of HRT should also include a balanced discussion of risks.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There is no discussion of costs in the article.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

Vague references to potential benefits of HRT with statements such as:

“(Drs) Johnson, Firouzbakht and other experts will tell you that hormone therapy protects against heart disease, a much more common killer of women than breast cancer, as well as against dementia, colon cancer, osteoporosis and other health issues.”

First, who are these “other experts” and where are the appropriate references for these claims?

Second, re-analysis of the data from the Women’s Health Initiative study shows:

  • only that HRT doesn’t increase risk in younger postmenopausal women – NOT that it is protective.
  • no data from the study show reduced risk of dementia.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The article states that conclusions of the Women’s Health Initiative have been discredited by subsequent studies but fails to state any of these studies or acknowledge potential side effects of HRT.  The article instead points out some of the limitations of the Women’s Health Initiative, but we don’t think “discredit” is appropriate in this case.  It was further analysis of the WHI data – not new studies – that showed that risks are different in the younger postmenopausal women (women in their 50s) compared with the older population.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The article contains quotes from two doctors who are very pro-HRT (one published a book about HRT), but the article itself only presents anecdotes and provides no references to actual studies showing benefits of HRT.

Does the story commit disease-mongering?

Not Satisfactory

The article presents several examples of disease mongering language as applied to menopause:

” It’s not a death sentence or a dependence…”

” You don’t have to suffer..”

” treatment can enable and boost a woman’s overall day-to-day existence”

” Too many women have been taught to accept suffering in this stage of life”

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

There was clear imbalance in the story. The article only presents quotes from two doctors who were supportive of HRT. It also failed to identify sources for some of the claims in the article.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The article was only focused on HRT and did not discuss any alternatives.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

HRT is available from your doctor, but at the end of the article, there is a statement that Dr Firouzbakht “prescribes pharmaceutical hormones and also works with a pharmacy she trusts to develop bio-identical hormone combinations for some patients. Such custom compounds are not FDA-approved.” The article goes on to state:

“It doesn’t matter what formulation of the hormones you are using, it’s the surveillance of it all that is very important,” Firouzbakht says.

These statements are confusing about the actual availability of HRT and hormones and dismisses the importance of FDA approval.

Does the story establish the true novelty of the approach?

Not Applicable

There is nothing novel about the approaches described in the story.

Does the story appear to rely solely or largely on a news release?

Satisfactory

We don’t see any evidence that the story relied solely or largely on a news release.

Total Score: 1 of 9 Satisfactory

Comments (1)

Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.

George

April 9, 2012 at 11:40 pm

Thanks for reminding me why I cancelled my subscription to this paper a couple of years ago.

Reply