Letters.

HRT Assumptions 'a Shame'

The ill effects of hormone replacement therapy reported in the Women's Health Initiative and the Heart and Estrogen! Progestin Replacement Study II apply only to Prempro and other continuous-combined HRT regimens, not to cyclic-sequential HRT ("Limit HRT Use to Symptom Control," Aug. 1, 2002, p. 1).

The assumption that the ill effects of Prempro are generalizable to all forms of HRT is a shame because it will scare women into stopping cyclic-sequential HRT--or never starting it. Indeed, cyclic-sequential and continuous combined HRT have different effects on the body and hence a different side effect profile. I have successfully used cyclic-sequential HRT to treat the dyslipidemia of the menopause for almost a quarter of a century, and my HRT clinic--which is small compared with the published studies but longer lived--does not have an excess of atherothrombotic heart disease or breast cancer.

W.E. Feeman, M.D.

Bowling Green, Ohio

Uterine Artery Embolization

In the largest reported series of uterine artery embolization for fibroids, postprocedural pain led to 20% of patients staying in the hospital more than 1 night, 5% staying more than 2 nights, and 3% being readmitted. Twenty percent of patients had no significant improvement in bleeding ("Recovery Fast in Uterine Fibroid Embolization," Aug. 15, 2002, p. 1).