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Editorial
February 2018

Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: Unfulfilled Expectations

Author Affiliations
  • 1Division of Cardiology, Department of Medicine, Emory University School of Medicine, Emory Women’s Heart Center, Emory Heart and Vascular Center, Atlanta, Georgia
JAMA Cardiol. 2018;3(2):99-101. doi:10.1001/jamacardio.2017.4575

In 1968, Robert A. Wilson, MD, a New York gynecologist, published Feminine Forever.1 In that book, he advocated that menopause was preventable and that hormone replacement therapy, as it was called at that time, would preserve the woman’s youthful appearance, keep her sexually attractive and potent, and preserve the strength of her bones. He further proposed that it could prevent breast and genital cancers as well as tension, irritability, headache, fatigue, depression, and insomnia. By the mid-1970s, about 30 million prescriptions for conjugated estrogen (Premarin; Pfizer Inc) were written annually in the United States, with this hormonal fountain of youth described by many as the greatest experiment ever performed on women. With subsequent identification that unopposed estrogen caused endometrial cancer, progestin was added to estrogen preparations in 1979.

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