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AWHONN NEWS |
AWHONN Statement on the
Estrogen Plus Progestin Trial of The Women's Health Initiative WASHINGTON, D.C., July 12, 2002 -- The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) today announced that it urges midlife women who are currently taking estrogen plus progestin to
have a serious talk with their professional health care provider (nurse practitioners, midwives, doctors and nurses)
to see if they should continue to take combination hormone replacement therapy (HRT). AWHONN’s
announcement comes as a result of recent research findings that the long-term risks of taking hormones outweigh
the benefits for a woman who still has her uterus.
On July 9, 2002, the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) announced that it has stopped a major clinical trial on the risks and benefits of combination estrogen and progestin treatment in healthy menopausal women. The trial was halted three years earlier than planned due to a slightly increased risk of invasive breast cancer. The study, a part of the Women’s Health Initiative (WHI), also found an elevated risk of coronary heart disease, stroke and pulmonary embolism in participating women taking estrogen plus progestin therapy as compared to the placebo group. While the trial found benefits to the estrogen/progestin combination, including reduced rates of hip fracture and colon cancer, overall the harm was greater than the benefit of the hormone combination. Prior to this study, HRT was believed to prevent heart disease. Approximately 6 million women in the U.S. are currently taking estrogen plus progestin. “AWHONN advises women who are currently taking estrogen/progestin therapy to have on-going discussions
about their individual situation with their health care provider, and re-evaluate this particular course of treatment,”
said Gail Kincaide, Executive Director of AWHONN. “However, researchers have indicated that there is no
reason for women who have been taking estrogen/progestin for a number of years to panic. For an individual
woman, the risk of suffering a serious adverse effect of hormone treatment is low. In fact, it may be reasonable
for some women to continue short-term use of combination hormone therapy to alleviate menopausal symptoms
such as hot flashes and night sweats.”
The study, involving more than 16,000 women ages 50 to 79, is the largest clinical trial to compare postmenopausal hormones with a placebo. Specific study findings for the estrogen plus progestin group compared to placebo include: · 41 percent increase in strokes · 29 percent increase in heart attacks · Doubling of rates of venous thromboembolism · 22 percent increase in total cardiovascular disease · 26 percent increase in breast cancer · 37 percent reduction in cases of colorectal cancer · one-third reduction in hip fracture rates · 24 percent reduction in total fractures · no difference in total mortality (of all causes) “AWHONN will continue to monitor additional results released from the WHI studies, inform nurses and others
about implications for nursing practice, and develop clinical practice recommendations for the care of women
that address these findings,” said Kincaide.
A full study report will appear in the July 17, 2002, issue of The Journal of the American Medical Association (JAMA), and is also available today on the JAMA web site at www.jama.com. About AWHONN A leader among the nation's nursing associations, the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) serves and represents more than 22,000 health care professionals in the U.S., Canada and abroad. AWHONN members are committed to delivering superior health care to women and newborns in hospitals, in home health and ambulatory care settings. AWHONN members' rich diversity of skills and experience make AWHONN the voice for women's health and neonatal nursing. Visit AWHONN on the World Wide Web at www.awhonn.org.
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