Halleluiah, lessons from the WHI by WHI people

For many years, the preliminary results of both arms of the Women's Health Initiative (WHI) were translated into very cautious, even negative recommendations in regard to the use of postmenopausal hormones. Despite the fact that further analyses from the WHI study, as well as data from other studies, should have dictated a more positive approach toward hormone therapy (HT) later on, the official position of the US health authorities has actually remained unchanged. Many societies, such as the International Menopause Society, the North American Menopause Society and the Endocrine Society, recently expressed their opinions in formal statements, which were generally more favorable. The main issues involved in the different interpretations of the same data related to the effect of age, recency of menopause, duration of therapy and the exact type of hormone used, which are all important determinants of the benefit-risk balance of HT. The new article in Obstetrics and Gynecology, written by several key WHI investigators, addresses the same issues by summarizing the WHI data in a rational way, which is much in line with that of most non-WHI opinion leaders. In a nutshell, it seems that their conclusions point at supporting the prescription of HT to young, healthy, symptomatic menopausal women, ascertaining treatment efficacy on the one hand while relieving the worries concerning its safety in this target population on the other hand. Can we reach at last a global consensus on the principles of HT use? Hopefully yes, but time will tell.