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Women misinterpret benefits and hazards of HRT

Physician Practice Advisor, December 13, 2004

Menopausal women continue to overestimate the real risks and benefits of hormone replacement therapy (HRT)-and so do their doctors, University of Florida (UF) researchers report in the American Journal of Obstetrics and Gynecology.

The confusion stems from widespread news accounts detailing findings from the federally funded, large-scale Women's Health Initiative (WHI) study, which assessed the major health benefits and risks of the most commonly used hormone preparations. The 2002 study showed that estrogen plus progestin increased the risk of heart disease, stroke, breast cancer, and blood clots in postmenopausal women who had used the combined therapy for about five years.

However, the media and WHI originally focused on describing the results in terms of a percent increase or decrease in relative risk, a definition of risk used by scientists but not usually by the general public, said Dr. R. Stan Williams, the Harry Prystowsky professor of reproductive medicine and associate chairman of obstetrics and gynecology at UF's College of Medicine.

As a result, many women in the UF study overestimated the risks, with a third of those surveyed believing hormone replacement therapy hikes the risk of heart disease 10% to 30% per year. Furthermore, 81% of the 1,076 respondents believed breast cancer risk increases for women on hormones, with slightly more than half believing the increase was as high as 10% to 30% per year.

In reality, in any given year, only about one additional case of breast cancer occurs among every 1,000 women receiving the treatment.

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