Doctors rethink impact of WHI on clinical practice: menopause group issues report: research suggests that timing may be key to treatment success, fewer adverse events.(News)

MIAMI BEACH -- The definitive study on the risks and benefits of hormone therapy may not be so definitive after all.

After more than a year of confusion and controversy in the wake of the Women's Health Initiative's early results, physicians at the annual meeting of the North American Menopause Society got a new message: Don't rely solely on WHI to guide your clinical practice.

"Those who stated shortly after the WHI results were released that [WHI] was the final nail in the coffin of hormone therapy were clearly wrong," Dr. Wulf Utian, NAMS executive director, told this newspaper. "On the other hand, the caution that's been counseled with regard to identifying women at risk of adverse events and monitoring hormone therapy patients very closely was correct."

Individual risk profiling of each patient is the best way to approach any regimen of hormone therapy, the society's Hormone Therapy Advisory Panel agreed in its new report on clinical practice recommendations.

"The absolute risks published thus far regarding [hormone therapy] are small, as are the benefits for bone and reduction in colon cancer risk," the new recommendations state.

"For women younger than 50, or those at low risk for coronary heart disease, stroke, osteoporosis, breast cancer, or colon cancer, the absolute risk from estrogen-progestogen therapy is likely to be smaller than demonstrated in WHI.... An individual risk profile is essential for every woman contemplating any regimen" of hormone therapy.

The new recommendations represent a natural evolution of thought since the headline-grabbing discontinuation of WHI's estrogen-progestogen arm, Dr. Utian said.