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Editorial
September 12, 2017

Menopausal Hormone TherapyUnderstanding Long-term Risks and Benefits

Author Affiliations
  • 1University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA. 2017;318(10):911-913. doi:10.1001/jama.2017.11462

The influence of hormone therapy on the health of women has been a subject of controversy for decades. In the 1960s, when estrogen therapy was first introduced for the treatment of menopausal symptoms, hormones were viewed as a fountain of youth. One of the early hormone advocates, Robert Wilson in his 1966 book about menopause and hormones, stated that “Instead of being condemned to witness the death of their own womanhood, [women] will remain fully feminine—physically and emotionally—for as long as they live…Menopause is curable.”1 What followed was a decade of unmitigated prescribing of unopposed estrogen (ie, without progesterone) for menopausal women both with and without a uterus. It then became clear that unopposed estrogen given to a woman with an intact uterus increased the risk of endometrial cancer,2 and hormone therapy fell from favor in the 1970s. This was followed by a resurgence of interest in hormone therapy when it became apparent that the administration of progesterone with estrogen could mitigate the increased risk of endometrial cancer.

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