Danger! Danger! HRT prescribing lagging behind recommendations

Posted by on Dec 6, 2010 in HRT | 0 comments


Here’s a disturbing piece of news:

Stanford University School of Medicine researchers are reporting that when it comes to prescribing practices, physicians across the country continue to lag behind recommendations from FDA and other organizations cautioning that hormone replacement therapy (HRT) should be used at the lowest dose and shortest period of time possible or only as a last resort. This, despite accruing evidence warning of the dangers of hormone therapy.

While use of hormonal therapy has gradually declined ,some 6 million women continue to place themselves at risk annually. This risk appears to be somewhat exacerbated by the fact that that their doctors, especially ob/gyns, have not changed their prescribing habits very much. Indeed, less than a third of hormone therapy users surveyed in the IMS National Disease and Therapeutic index (which formed the basis for this latest bit of information) were given prescriptions for lower-dose hormone pills, vaginal suppositories or patches. Especially at risk are women old than 60 years in whom the risk/benefit of HRT is very unbalanced, more than a third of whom continue to use hormonal therapy to address symptoms. Thankfully, however, women younger than 50 and up to age 59 appear to be paying attention to the headlines and giving up hormones altogether.

Although the reasons that doctors aren’t paying attention are unclear, the researchers suggest that perhaps clinical practice has not caught up with data or that older women in particular, are satisfied with symptom control and don’t want to rock the boat.  Or perhaps many women in this age group remain unaware of the increased risk of heart disease and breast cancer (among others) associated with menopausal hormonal therapy. Regardless, the message isn’t getting through.

How do you change prescribing habits when there’s a breakdown in communications or when study investigators suggest that “it takes a huge event to change clinical practice?”  A huge event? I don’t know about you but I think that increases in heart disease and cancer risks are pretty big events. Ladies – it’s time to take this matter into your own hands. Speak up. Work with your doctor, discuss the treatment strategy he or she is recommending and especially when it comes to HRT, ask the hard questions.

Right now, like Robot from ‘Lost in Space,’ I don’t think that we can accept any other course of action other than to take action.

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