PubMed · 15458940
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American College of Obstetricians and Gynecologists Women's Health Care Physicians. 2004. Stroke.. https://doi.org/10.1097/01.aog.0000138793.60709.5f
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This new statement from EMAS presents the findings reported in recent publications from both WHI and the Nurses' Health Study to consider if these findings require the EMAS position to be modified. In general the reports do not necessitate a revision of the current EMAS advice but do provide further insight into the ongoing controversy around the possibility that estrogen (E) or estrogen-progestogen (E-P) use in younger postmenopausal women may supply cardiovascular benefit in the younger group.
OBJECTIVE: Data from placebo-controlled, randomized clinical trials conducted during the past few years resulted in critical re-evaluation of the overall health benefits of hormone therapy (HT) in women during the menopausal transition and thereafter. These data stimulated vigorous debate among experts and produced several position papers by North American and European authorities providing guidance on the use of HT. It is well known that cultural, geographic and ethnic differences influence the acceptance and risk perception of HT. Therefore, it was considered essential to present a position specifically relevant to Latin American countries. METHODS: A Latin American Expert Panel, convening in Salvador, Bahia, Brazil, obtained consensus on recommendations for HT that incorporated the findings of the most recently published reports. The panelists' opinions were surveyed by means of the Likert scale along five categories ranging from complete agreement to complete disagreement. RESULTS: The Panel presented 13 recommendations and considered three additional issues relevant to HT use. There was consensus that HT during the perimenopause and thereafter is warranted in Latin American women in particular for the management of vasomotor symptoms. HT may also be an option for osteoporosis prevention in women at significant risk, after evaluation of risks/benefits and after consideration of alternative therapies. HT should be individualized and prescribed at the lowest effective dose. CONCLUSIONS: The Panel concluded that HT remains a safe and effective treatment option for peri- and postmenopausal Latin American women.
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