From the Editor

Recent years have brought forth data refinements and age-stratified information from the Women’s Health Initiative (WHI). These data have enabled a better understanding of the role of postmenopausal hormone therapy (HT) and its benefit/risk equation, especially with respect to cardiovascular disease. New information on HT, together with the emergence of nonhormonal options for vasomotor symptoms and other menopause-related health issues, makes it imperative for clinicians to understand the new paradigm in evaluating and treating women at midlife.

This supplement was conceived to make internists, cardiologists, and other physicians caring for midlife women aware of this newer research, which indicates compellingly that the benefit/risk equation for HT use in younger symptomatic menopausal women is quite favorable. Since these data suggest that there may be actual cardiovascular benefit and mortality reduction with HT use in younger women, it is critical that physicians be familiar with this newer evidence in order to help their women patients make informed and individualized choices with respect to both long-term health and quality of life.

We begin with noted women’s health cardiologist and researcher, Dr. Howard N. Hodis, who elucidates the latest cardiovascular data with respect to HT and provides a fascinating comparison of risks between HT and other drugs commonly used in midlife women. Then Dr. Margery Gass, a WHI investigator and North American Menopause Society (NAMS) leader, interprets WHI research and highlights key recommendations from a recent NAMS position statement on HT use in peri- and postmenopausal women. Next, women’s health specialists Drs. Marjorie R. Jenkins and Andrea L. Sikon review nonhormonal therapies for menopausal problems. We conclude with an interactive discussion of actual case studies presented by obstetrician-gynecologist Dr. Margaret McKenzie.

Our approach is interdisciplinary, focusing on choice and individual options. Our aim is to update physicians who are not women’s health specialists on the latest benefit/risk balance associated with HT and nonhormonal therapies.

Holly L. Thacker, MD, FACP, CCD
Director, Women’s Health Center, Cleveland Clinic
thackeh@ccf.org

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