Khalid Mahmud
The Women’s Health Initiative [WHI] study ended in 2002 because of the adverse effects of Premarin and Provera, including cardiovascular events [heart attack, stroke and pulmonary embolism] which affected 7% of the participants, and almost doubling the risk of breast cancer and mammographic abnormalities. It led to a major reduction in the use of hormone therapy for menopausal women, with significant consequences in terms of quality of life and possibly overall health. The following is a report of 460 menopausal women, who were administered multiple hormones, according to a rationalized approach described below. All patients received bio-identical estrogen and progesterone; 227 and 349 received testosterone and DHEA, respectively for suboptimal levels; 103 received thyroid replacement, and 89 received a growth hormone secretagogue for suboptimal Insulin like Growth factor [IGF]. No patient developed any cardiovascular complications over an average duration of four years. Premarin and Provera would have resulted in 33 such events. There were no hormone related breast cancers and no increase in mammographic abnormalities. In fact, eight abnormal [dense/cystic] mammograms showed improvement on follow up. There is a need to look into fresh approaches that could improve the quality and possibly quantity of menopausal years.
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