Management of Menopause-Related Symptoms
Authors: Carol M. Mangione, Donna L. Washington, Paul Woolf
Journal: Annals of Internal Medicine (2005)

Letters6 December 2005Management of Menopause-Related SymptomsCarol M. Mangione, MD, MSPH, Donna L. Washington, MD, MPH, and Paul Woolf, MD, MBACarol M. Mangione, MD, MSPHFrom the David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA 90024; VA Greater Los Angeles Healthcare System, Los Angeles, CA 90012; and Crozer Chester Medical Center, Upland, PA 19013.Search for more papers by this author, Donna L. Washington, MD, MPHFrom the David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA 90024; VA Greater Los Angeles Healthcare System, Los Angeles, CA 90012; and Crozer Chester Medical Center, Upland, PA 19013.Search for more papers by this author, and Paul Woolf, MD, MBAFrom the David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA 90024; VA Greater Los Angeles Healthcare System, Los Angeles, CA 90012; and Crozer Chester Medical Center, Upland, PA 19013.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-11-200512060-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Danby correctly notes, as reported in our statement, that the Women's Health Initiative randomized, controlled trial revealed an increased risk for breast cancer in women taking estrogen combined with medroxyprogesterone acetate (1). Although the safety profile for this progestin may differ from that of “natural” progesterone, this issue, to our knowledge, has not been studied in adequately powered randomized clinical trials. Of note, small studies that failed to meet established quality grading were excluded from the panel's purview. We feel that Dr. Danby is confusing the lack of well-designed studies to determine the safety and efficacy of ...References1. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized, controlled trial. JAMA. 2002;288:321-33. [PMID: 12117397] CrossrefMedlineGoogle Scholar2. Bhavnani BR. Estrogens and menopause: pharmacology of conjugated equine estrogens and their potential role in the prevention of neurodegenerative diseases such as Alzheimer's. J Steroid Biochem Mol Biol. 2003;85:473-82. [PMID: 12943738] CrossrefMedlineGoogle Scholar3. Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998;280:605-13. [PMID: 9718051] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Carol M. Mangione, MD, MSPH; Donna L. Washington, MD, MPH; Paul Woolf, MD, MBAAffiliations: From the David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA 90024; VA Greater Los Angeles Healthcare System, Los Angeles, CA 90012; and Crozer Chester Medical Center, Upland, PA 19013.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNational Institutes of Health State-of-the-Science Conference Statement: Management of Menopause-Related SymptomsNIH State-of-the-Science Panel*National Institutes of Health State-of-the-Science Conference Statement: Management of Menopause-Related SymptomsNIH State-of-the-Science Panel*Management of Menopause-Related Symptoms F. William Danby Metrics 6 December 2005Volume 143, Issue 11Page: 846KeywordsBreast cancerClinical trialsEstrogensLongitudinal studiesObstetrics and gynecologyProgesteroneRisk managementSafetySafety studies ePublished: 6 December 2005 Issue Published: 6 December 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...