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3 Comments

  1. 1

    ron batagol

    There are two separate issues here. Firstly, I have no problems with the author’s concerns about Industry ghost writers. On the other hand, I do take issue with her comments that “despite definitive scientific data to the contrary, many gynecologists still believe that HRT’s benefits outweigh the risks in asymptomatic women. “This non-evidence–based perception may be the result of decades of carefully orchestrated corporate influence on medical literature,” In fact, the data with respect to risks of short-term use of HRT is far from definitive. The WHI Study that she seems to heavily rely upon for her “definitive evidence” has been acknowledged to have had major flaws in its design, by a number of authoritative sources, quite apart a from those who have had a commercial or vested interest in promoting the use of HRT ( eg. Klaiber et al. Fertil Steril 2005; 84:1589). Also as noted by clinical Peak Bodies such as the RACOG, the cohort selected by WHI for their Study were an older age group with a higher risk of adverse disease outcomes, and using the drugs for a longer period than the majority of women using HRT. As one who has followed the literature on HRT for some time, as a peripheral issue, I am intrigued that very few people mention that the WHI Study found a DECREASE IN INCIDENCE of bowel cancer and hip fractures!

    In summary, it’s great that she is pursuing the important issue of ghost writing, but a shame that she has taken such leaps of faith in devising various conclusions regarding the risks of HRT

    Ron Batagol, Pharmacy & Drug Information Consultant

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  2. 2
    Melissa Sweet

    Melissa Sweet

    The bigger picture is that for years, the pharma industry, working closely with some specialists, promoted a treatment for widespread use in healthy women on the basis that it would prevent disease. This was done on the basis of inadequate and misleading evidence. The lack of a subsequent mea culpa or even a “what can we learn from this history” has been striking.

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  3. 3

    ron batagol

    Yes, it’s true as Melissa notes that, for all the reasons she mentions, HRT was promoted and recommended for years for the prevention of cardiac disease and coronary artery disease for many years. However, it is also true that both RACOG and the NHMRC identify that there is good evidence that HRT does prevent the onset of osteoporosis in otherwise healthy menopausal women. BTW, since I don’t recall them being mentioned, I hope that in the “bigger picture”, deprecating the pharma industry also includes the purveyers and promoters of the ubiquitous use of bioidentical hormones for all and sundry assorted menopausal “diseases”, with unknown adverse effects and without objective high-quality evidence of efficacy.

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