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Reuters Health deftly reports new data on hormone therapy for menopause

Rating

5 Star

Tags

Menopause hormone therapy not linked to premature death

Our Review Summary

This is a story about a study that follows-up on the long-term effects of hormone therapy on the risk of death.  The findings show that women who took combined hormone therapy (estrogen and progesterone) for approximately 5 years, or who took estrogen alone for 7 years, had the same risk of death 18 years later as those who had taken no hormone therapy.

Thus the small increases in risk of developing breast cancer and (mainly in older women) heart disease with combined hormone therapy did not translate into an increased risk of death.

The story does a good job describing the findings, and how the study was designed. The inclusion of an independent source also strengthened the reporting. A discussion of the costs would have made it even stronger.

 

Why This Matters

The subject of women and menopause and hormone therapy has been debated for decades. This new study, which shows no significant difference in death rates for women who did or did not take hormone replacement, is important. But the take-home message, which is also important, is that each woman has to talk about risk vs. benefit with her own health-care practitioner in order to understand the nuances. This story will help women make an informed choice.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

No information is given on the cost of a typical course of treatment.

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

Not Applicable

This study does not aim to quantify the benefits of treatment, rather to show whether there is any difference in risk of death associated with taking hormone therapy for 5 to 7 years.  The original Women’s Health Initiative trial was designed to examine whether there was any benefit of hormone therapy for prevention or heart disease, which had been suggested by earlier studies.

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

Satisfactory

The story does a good job of outlining the complicated history of findings from hormone replacement studies, and the harms and risks, and uses numbers to explain the risks.

There is great nuance in the findings, which can be interpreted differently for women of different ages seeking HRT. Women bring different life risks of cardiovascular disease or breast cancer with them into any discussion of HRT.

The conclusion quoted in the story may be less-than-reassuring, but is here:

“Hormone therapy has been in and out of favor – first it was good for all menopausal women, then it was dangerous for all women,” McNeil said. “The take-home message now is that for the right patient, hormone therapy is safe and effective.”

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

Satisfactory

The story does a good job of describing how the study was done and establishing the high-quality of evidence from a large randomized trial.

Does the story commit disease-mongering?

Satisfactory

There was no disease mongering.

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

Satisfactory

The story included an independent source and there does not appear any conflicts of interest that should have been disclosed.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story is about alternatives, on its face, about the alternative of taking or not taking hormone replacement therapy. We wish there had been a sentence or two more on how other methods are available to women to ease symptoms.

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

Satisfactory

These therapies are widely available and that’s implied in the story.

Does the story establish the true novelty of the approach?

Satisfactory

The story makes it clear that this is a new analysis that looks at long-term data on deaths years after use or non-use of hormone therapy.

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

Satisfactory

The story includes original reporting and does not rely solely on the news release.

Total Score: 8 of 9 Satisfactory

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