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Giving Menopause Its Proper Place

Bethany Hayes, MD

Abstract
For the last 50 years, medicine has treated an increasing number of postmenopausal women with hormone replacement therapy (HRT). The accepted thinking was that women who took HRT were healthier than those who did not. Then came the Women’s Health Initiative, a large, well-designed study sponsored by the National Institutes of Health1 while it was under the direction of Bernadine Healy, MD, the first woman to head that organization. When the study was stopped in midstream for safety issues in July 2002, its findings literally turned women’s health on end.

It appeared that HRT offered no health benefits and, ironically, actually increased risk for more blood clots and strokes and possibly increased risk for breast cancer. Since this time, many reviews of the study have both supported and criticized its findings. For women with menopausal symptoms and their doctors, this has been quite confusing. Is HRT really necessary, or are there other ways to control hormone needs as menopause is experienced? To answer those questions you have to examine what goes on during menopause and how a woman’s changing body actually uses hormones.

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