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This Week in JAMA: Apr 6, 2011

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The Women’s Health Initiative study of estrogen therapy in women with hysterectomies was stopped early in 2004 due to an increased risk of stroke, and in a new study published this week in JAMA, researchers from the WHI report on the long-term health outcomes of the women in that study after stopping therapy. The women in the double-blind, placebo-controlled, randomized clinical trial received either conjugated equine estrogens or placebo for a median of 5.9 years, and then were followed for a mean of 10.7 years. "Several patterns of health risks and benefits seen during the intervention period were not maintained during the postintervention period, while other trends persisted," the authors write. The therapy was not associated with either an increased or decreased risk of coronary heart disease, deep vein thrombosis, stroke, hip fracture, colorectal cancer, or total mortality, the authors report. It was associated with a decreased risk of breast cancer.

In an accompanying editorial, physicians from Washington University School of Medicine say "there may still be a role for short-term use of unopposed estrogen for treating some women with menopausal symptoms, but this role may be vanishing as existing and emerging data continue to be better understood in terms of application to patients."

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