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Estrogen avoidance following WHI increased mortality rates in hysterectomized women
Less than 2 years following the published results of the Women’s Health Initiative from 2002, approximately half of the women in the United States using systemic hormone therapy halted treatment — including almost 2 million women who had undergone hysterectomies, according to researchers. In a recent analysis, Philip M. Sarrel, MD, and colleagues wrote that this avoidance of estrogen use increased mortality rates among those who underwent a hysterectomy.
“Sadly, the media, women and health care providers did not appreciate the difference between the two kinds of hormone therapy,” Sarrel, an emeritus professor in the departments of obstetrics, gynecology and reproductive sciences, and psychiatry at Yale-Griffin Prevention Research Center, said in a press release. “As a result, the use of all forms of FDA–approved menopausal hormone therapy declined precipitously.”
Philip M. Sarrel
The researchers examined the relationship between excess mortality in women aged 50 to 59 years who underwent a hysterectomy and were assigned placebo in the Women’s Health Initiative (WHI) trial and a population of comparable women in the US. The drop in estrogen use between 2002 and 2011 was factored into their analysis.
According to the researchers’ Mortality Toll of Estrogen Avoidance (MTEA) formula, during a 10–year period (beginning in 2002), at least 18,601 or as many as 91,610 postmenopausal women died prematurely due to the avoidance of estrogen therapy, they wrote.
“Estrogen avoidance has resulted in a real cost in women’s lives every year for the last 10 years — and the deaths continue,” Sarrel said. “We hope this article will stir an overdue debate and raise consciousness about the health benefits of estrogen-only therapy for women in their 50s with no uterus.”
Disclosure: Sarrel reports consultancy for Noven Therapeutics. All other researchers report no relevant financial disclosures.