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To The Editor: The study by Dr Cushman and colleagues¹ is based on data from the WHI and details of the methods are reported in an earlier JAMA publication.² The prior study notes that of the 8506 participants in the CEE + MPA group, 3444 (40.5%) were unblinded for control of vaginal bleeding. Further, CEE and/or MPA doses could have been altered for treatment of this condition, yet no published data from this trial have indicated the effect that this treatment had on the study outcomes. It seems inaccurate to label this a blinded controlled trial of placebo against CEE + MPA.

Richard E. Blackwell, PhD, MD
rblackwe@uabmc.edu
Department of Obstetrics and Gynecology
Division of Reproductive Endocrine and Infertility
University of Alabama
Birmingham

1. Cushman M, Kuller LH, Prentice R, et al, Women's Health Initiative Investigators. Estrogen plus progestin and risk of venous thrombosis. JAMA. 2004;292:1573-1580. FREE FULL TEXT 2. Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results of the Women's Health Initiative Randomized Controlled Trial. JAMA. 2002;288:321-333. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293:1322.

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