Hrt: need for better trials
The benefits of hormone replacement therapy could be cancelled out by their risks, according to an editorial in the New England Journal of Medicine.
A large epidemiological study following nearly 50,000 women for 10 years found thatthose taking HRT had half the risk of major coronary disease than their control counterparts.
However, according to the editorial, this potential benefit could be cancelled out by the sixfold increase in the risk of death from endometrial cancer and the increased risk of breast cancer by one and a third times.
Furthermore, this cardiac benefit only occurred with women taking oestrogen alone.
No one knows if the benefits are nullified by adding progestogens, as is now recommended to prevent the cancers named above.
And besides which, said the editorial, many biases could be built into these studies, which so far have simply followed women taking these drugs against matched controls.
In other words, to date, there has never been one single randomized double blind trial to prove that there are any benefits at all to taking HRT or how extensive the risks are, a situation the journal insists ought to be rectified before anyone takes a side, pro or con.