HRT: The argument against

Shlomo Berliner*

*Corresponding author for this work

Research output: Contribution to journalComment/debate


The pendulum concerning HRT, which had swung higher and higher towards the end of the last millennium, dropped steeply following the recent publication of the HERS and WHI studies. However, as long as 50-80% of relatively young postmenopausal wowen continue to suffer from vasomotor symptoms, and in the absence of good alternative treatment, HRT will continue to be used by many millions of wowen. (We must bear in mind that the worldwide number of postmenopausal wowen currently approaches 1 billion). HRT is currently not recommended for chronic disease prevention in postmenopausal women. Recently, a few selected groups of women were identified who might react to HRT differrently from the general population. These include women with increased cardiovascular risk due to elevated serum lipoprotein (a) levels [1,4] who may benefit from HRT, women with mutation in the prothrombin gene who are at increased risk of developing cardiovascular complication early in the course of HRT [5], and certain interleukin-6 gene variants (IL-6-174C) that cause increased mineral bone density in response to HRT [6]. A possible futuristic setup might enable us to perform personal genetic profiles that will help us decide the advantages vs. disadvantages of HRT in individual women. Until then, I believe we should adopt the current U.S. Food women to use HRT only for menopausal symptoms at the smallest effective dose for the shortest possible time [7].

Original languageEnglish
Pages (from-to)644
Number of pages1
JournalIsrael Medical Association Journal
Issue number10
StatePublished - Oct 2004
Externally publishedYes


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