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May 21, 1997

Estrogen Replacement Therapy: New Options, Continuing Concerns

Author Affiliations

St Joseph's Hospital Milwaukee, Wis

JAMA. 1997;277(19):1515. doi:10.1001/jama.1997.03540430027015

To the Editor.  —The articles by Dr Speroff and colleagues1 and the Writing Group for the Postmenopausal Estrogen/ Progestin Intervention (PEPI) Trial2 address a number of relevant issues regarding postmenopausal hormone replacement therapy (HRT) and lend additional weight to the growing body of evidence that suggests that continuous combined estrogen-progestin therapy may be the optimal regimen for HRT in women with an intact uterus. The Editorial by Dr Insogna and colleagues3 further states that the data from the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial and the Continuous Hormones as Replacement Therapy (CHART) study suggest that continuous conjugated equine estrogen-medroxyprogesterone acetate (CEE-MPA) is superior to continuous norethindrone acetate—ethinyl estradiol (NA-EE2) in terms of effect on lipid profile. By highlighting key findings in the 2 studies, the Editorial provides useful direction for clinical decision making. However, both the Editorial's authors and The Journal's editors appear to have ignored disturbing