NIH paper reveals faltering faith in HRT as panacea: HRT for heart, fractures questioned but seen as helpful for vasomotor symptoms, atrophy. (Summarizes Data From Clinical Trails).

A new report from an international panel of experts signals just how much enthusiasm has cooled toward prescribing hormone replacement therapy as a cure-all regimen around the time of menopause.

The position paper, which will be released in its entirety this month by the National Institutes of Health, attempts to tie together a decade's worth of the best available evidence concerning every aspect of menopause, from managing symptoms to sexuality and cultural issues. The publication, a chapter of which was released at a recent symposium on estrogen and menopause, was a collaborative effort organized by the National Heart, Lung, and Blood Institute and the private Giovanni Lorenzini Medical Foundation, based in both Milan and Houston.

Regarding hormone replacement therapy (HRT), the report emphasizes that evidence from disparate studies over the years has been unfavorable.

In fact, for almost every aspect of postmenopausal health, there are now alternatives to HRT that have been proven to be more effective and safer for targeted uses.

Dr. Victoria Kusiak, vice president of global medical affairs and North American medical director at Wyeth Pharmaceuticals, emphasized in an interview that HRT is still the most effective option for treating vaginal atrophy and vasomotor symptoms.

In addition to these indications, HRT is approved for the prevention of bone mineral loss. It is not approved, however, for fracture prevention.

The unprecedented report, which was written by a 24-member committee, stands in contrast to guidelines released a decade ago from groups such as the American College of Physicians, which encouraged physicians to prescribe HRT to most menopausal women for its presumed benefits to cardiovascular, bone, neurologic, and urogenital health.