Variations on HRT.
Apart from the sadness of infertility, women with a premature menopause have a higher incidence of osteoporosis, coronary heart disease, stroke and also depression (30). Indeed it was this association which led to the concept of estrogens preventing these chronic diseases in older women. Estrogen therapy has been shown to increase the bone density and also to improve the histomorphometric parameters of strength of bone even in young women with Turner’s syndrome (31). They need HRT in the appropriate dose for these symptoms until at least until the age of 50, the time of the normal menopause. If there is to be a 5-10 year recommended limit for the duration of HRT, these treatment years should be counted from the age of 50, the age of natural menopause. In reality these young women with their excess risk of chronic disease are having their estrogen therapy discontinued or not started due to the anxiety created by the common misinterpretation of the WHI data.