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RCOG recommendations on hormone replacement therapy.

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Malcolm I Whitehead, RCOG study group on menopause and HRT. RCOG recommendations on hormone replacement therapy.. https://doi.org/10.1016/s0140-6736(05)17973-2

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Changes in newspaper coverage about hormone therapy with the release of new medical evidence.

BACKGROUND: Results of 2 trials of postmenopausal hormone therapy (HT) challenged established practice patterns; 1 was not associated with changes in HT use, whereas the other was associated with substantial decline. Differential coverage by lay newspapers may have contributed to the differential impact. OBJECTIVE: To examine newspaper coverage of HT before and after the publication of the Heart and Estrogen Replacement Study (HERS) in August 1998, and the main findings of the estrogen plus progestin therapy arm of the Women's Health Initiative (EPT-WHI) in July 2002. DESIGN: Longitudinal review of newspaper articles, 1998 to 2003 (n=663). SETTING: Twenty local and 6 regional/national newspapers. MEASUREMENTS: Number and content of articles about HT. RESULTS: The average number of articles about HT published during the month of the publication of the EPT-WHI was at least 8-fold greater than the number of articles published on the topic during any prior period. While the majority of articles in all periods presented information about the potential benefits of HT, information about harms became more common than information about benefits during the 2 months before the publication of the EPT-WHI, when the trial participants were notified of the early termination of the study. The presentation of specific health harms was more common after the publication of the EPT-WHI than after the publication of HERS. Few articles in any period used visual aids. CONCLUSIONS: The publication of the EPT-WHI was associated with a change in both the volume and content of newspaper coverage about HT.

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Hormone replacement therapy and stroke: the current state of knowledge and directions for future research.

The Women's Health Initiative, which reported an increased risk of stroke with hormone therapy (HT), has had a major impact on the use of these drugs. The increased risk was unexpected because experimental animal studies showed estrogen reduced stroke volume and estrogen improves endothelial-dependent blood flow and improves lipid profiles in humans. The mechanisms of risk are uncertain because of the complexity of actions of estrogen in different doses, with or without progesterone, and the presence or absence of atherosclerotic risk factors. Therefore, future research should focus on identifying the mechanism(s) of risk, determining the differential impact of estrogen on stroke compared with heart disease, and identifying women with vasomotor symptoms who may be at risk of stroke with short-term HT use.

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