When a dream comes through…

Abstract

This is a follow-up of a paper ''My dream '' published in Climacteric (2004;7:322-3) in which it was imagined that the WHI investigators would one day apologize to the women of the world for the unjustified damage they has caused with the misinterpretation of the WHI results. Time has shown that this is about to happen as the recent reanalysis of the study show that, contrary to what they had written, HRT does protect from cardiovascular diseases when started in the early postmenopause. Furthermore comments are made about the political background of the reported results as a disservice to the medical community and to the women, themselves.I at once felt that there was something wrong about the noise that had been generated by the release of the results of the Women's Health Initiative (WHI) study.I read it again and again and, much to my astonishment, my interpretation of the announced results did not match with what had been divulgated. Therefore I decided to publish my own conclusions [1] which clearly indicated that women under 60 years of age, with vasomotor symptoms, were not at risk of cardiovascular diseases (CVD) while being treated with estrogens plus progestins. The National Institutes of Health (NIH)/WHI investigators had concluded otherwise, saying that 'the findings applied to all women, regardless of age or health status' [2].Furthermore, although I did understand that the design of such a clinical trial required that all women had to take the same dose of the tested medication, as a clinician I could not accept that older women were medicated with doses much higher than what their age required. Obviously this resulted in a large number of dropouts due to side-effects (uterine bleeding, etc.).Consequently the WHI results could not be extrapolated into good clinical practice as pretended by the WHI investigators.There was something wrong. Among those who participated in the WHI there were, no doubt, many good clinicians who could not apply those data in their daily practice as menopause caregivers! It was then that one night I had a 'dream' which I shared with the readers of Climacteric [3]. I imagined that the day would come when the WHI investigators would apologize to women, all over the world, for the damage they had caused with their wrong advice. I imagined that a message was being sent, through the news agencies, by many physicians to women all over the world: 'We, the physicians who participated in a widely publicized study, known as the Women's Health Initiative (WHI), deeply regret that our results were so severely misinterpreted by the media and also by a large segment of the medical profession . . . As investigators of that study we did our best to accurately report the findings. However, as physicians, we feel a collective responsibility to explain to all women and doctors what these results meant in order to avoid the ongoing misinterpretations . . . As physicians we feel an ethical and social responsibility to tell the people, beyond our frontiers, wherever those results have...