Hormone Therapy Decision Guidelines

Here are several points to help you summarize the findings of the Women's Health Initiative (WHI) study:

First, it's important to know that, because the study involved healthy women, only a small number of them had either a negative or positive effect from estrogen plus progestin therapy. The percentages describe what would happen to a whole population-not to an individual woman. For example, the increased risk of breast cancer for the women in the WHI study who were taking the estrogen plus progestin therapy was less than a tenth of 1 percent each year. But if you apply that increased risk to a large group of women and over several years, then the number of women affected becomes an important public health concern. About 6 million American women take estrogen plus progestin therapy. That would translate into nearly 6,000 more cases of breast cancer every year- and, if all of the women took the therapy for 5 years, that might result in 30,000 more cases of breast cancer.

Second, bear in mind that percentages aren't fate. Whether expressing risks or benefits, they do not mean you will develop a disease. Many factors affect that likelihood, including your lifestyle and other environmental factors, heredity, and your personal medical history. Finally, realize that most treatments carry risks and benefits. No one can make a treatment choice for you. Talk with your doctor or other health care provider and decide what's best for your health and quality of life. Begin by finding out your personal risk profile for heart disease, stroke, breast cancer, osteoporosis, colorectal cancer, and other conditions. Discuss quality of life issues and alternatives to postmenopausal hormone therapy with your health care provider. Then, weigh every factor carefully and choose the best option for your health and quality of life. And keep talking with your health care provider-your health status can change and so can your choice.