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CLINICIAN'S CORNER
A 60-Year-Old Woman Trying to Discontinue Hormone Replacement Therapy
Deborah Grady, MD,MPH, Discussant
JAMA. 2002;287:2130-2137.
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INTRODUCTION
DR REYNOLDS: Mrs W is a 60-year-old white woman who is trying to discontinue her estrogen therapy. She lives alone near Boston and teaches middle school. Her 29-year-old son lives in another state. She has managed care insurance.
At the age of 40, Mrs W underwent hysterectomy and bilateral salpingo-oophorectomy to treat refractory endometriosis. After several days of severe flushes, sweats, and depression, she began taking conjugated estrogen, 0.625 mg/d. With that therapy she has felt well for the past 2 decades. Over the past few years, she became increasingly concerned about her family history of breast cancer and the health risks of postmenopausal hormone replacement therapy (HRT) after reading about it in the lay press. Mrs W asked her former physician about these risks, and he encouraged her to continue treatment. At times, she discontinued the estrogen on her own, but disabling hot . . . [Full Text of this Article]
MRS W: HER VIEWS
DR K: HER VIEWS
AT THE CROSSROADS: QUESTIONS FOR DR GRADY
Indications for Postmenopausal Hormone Therapy Postmenopausal Hormone Therapy for Treatment of Menopausal Symptoms Hormone Therapy for Prevention of Disease Prevention of CHD Prevention of Osteoporotic Fractures Increased Risk of Breast Cancer Who Should Take HRT for Prevention? Discontinuing Postmenopausal Hormone Therapy What About Preventive Therapy With Tamoxifen or Raloxifene? Summary and Recommendations for Mrs W
QUESTIONS AND DISCUSSION
Author Affiliation: Dr Grady is Professor of Epidemiology and Medicine, Department of Epidemiology, University of California, San Francisco.
RELATED LETTER
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