Why there was a decline in estrogen and progesterone

(EHT) prescriptions in the USA in recent decades ?

  Use of EHT decreased approximately 80 percent since the initial publication of the Women's Health Initiative (WHI) study results in 2002. (1) The original results of this very large and expensive study erroneously concluded that estrogen is very harmful and generally should not be used. Due to this study many physicians discontinued prescribing any type of estrogen altogether.  Recently there have been many excellent studies proving wrong the original WHI results and even the WHI now  states that estrogen and progesterone are safe to use for control of menopausal symptoms if  there are no contraindications. In spite of abundant data demonstrating the safety of MHT in younger postmenopausal women, prescription rates have remained extremely low. Estrogen is now prescribed to only 3 to 4 percent of peri/postmenopausal women, down from 25 to 30 percent before the WHI study. There is evidence that nowadays the trend is changing and more women are considering estrogen and progesterone replacement therapy.  At CH medical we are watching very closely for any new developments redarding safety of estrogen and progesterone and at this time we would prescribe estrogen and progesterone to patients who have valid indications and have no contraindications. We provide close follow up in order to ensure our patients are safe and have no side effects.

Safety first.

1. A sustained decline in postmenopausal hormone use: results from the National Health and Nutrition Examination Survey, 1999-2010. Sprague BL, Trentham-Dietz A, Cronin KA . Obstet Gynecol. 2012 Sep;120(3):595-603.