Estrogen story overplayed

Re “Doctors change course again on estrogen therapy,” June 21

The Times’ dramatic lead story on the latest findings from the Women’s Health Initiative study creates the misimpression that there will be an important shift in treatment patterns based on this report.

Although the data are reassuring in regard to heart disease risk from estrogen replacement in early menopause, the overall treatment issues in any given woman involve much more than just heart disease risk.

As the article states, this study will primarily serve to reinforce the current standard practice: that estrogen should be used only for menopausal symptoms and that a low dose for the shortest treatment period is optimal.

Overdramatizing the relatively small pendulum swings in our understanding of these issues creates the misimpression that medical recommendations reflect merely the latest study and will remain valid only until another study arrives.

In reality, in most important areas of medicine, treatment practices and recommendations are based on extensive and well-validated research.

Practice patterns will always evolve in response to new data, but in estrogen replacement, as in other areas, the trend is much more likely to emphasize continuity than abrupt change.

DANIEL J. STONE MD

Beverly Hills