Better Bones, Hearty Hearts First came osteoporosis in the 1980s. Premarin was pitched as a remedy for brittle bones. Randomized data finally supported those claims. But still lacking is good data on when therapy should be started and in whom and in what dosage. Obviously, sales go up if women begin therapy at the beginning of menopause or even sooner.
Trouble is, some data suggest treatment in later years is just as effective.
Observational studies, which involved pulling patient records and looking back in time, caused quite a stir, showing lower rates of coronary heart disease in women who take postmenopausal estrogen. It's been assumed that the lowering of bad cholesterol and the increase of good cholesterol played a strong role in these results. A similar positive effect on cholesterol found in this week's study, however, didn't translate into a prevention of heart attacks or death from coronary heart disease. Maybe heart disease is more complicated than medicine has imagined. More overdue randomized research is under way.