[What is the actual lesson from the WHI study upon its completion?]

The issue of hormone replacement therapy (HRT) in postmenopausal women has been influenced recently by negative attitudes of the media and health authorities, based on misinterpretation of the results of the Women's Health Initiative (WHI). This atmosphere led to the discontinuation of HRT in women with menopausal symptoms, because of fear and anxiety created by overestimated harmful effects of hormones. Careful evaluation of the data in the estrogen-progestin arm shows that the reported risk for breast cancer and cardiovascular events was at the most minute, in the order of 0.1% (1 thousandth) excess in risk for every year of use. No risk was observed for women younger that 60 years of age. Preliminary data of the estrogen-only arm points at a non-significant reduction in risk for both coronary events and breast cancer. While the WHI study recruited women in their late 60's who were assigned to receive a standard dose of HRT, the typical woman who seeks consultation at the menopause clinic is much younger in age and usually suffers from menopause symptoms. Therefore, the results of the WHI study simply do not apply to the usual clinical set-up at the menopause clinic in Israel.