Studies have found a close association between industry funding for speaking, consulting or research and promotional pieces of the publication on menopausal hormone therapy. The publications may boost physicians to continue prescribing these hormone therapies to women of menopausal age.
Over the past three decades, menopausal hormones have been heavily promoted for preventing disease in women. However, the 2004 federally-funded Women's Health Initiative study that enrolled more than 26,000 women in the USA found that the most popular estrogen-progestin and estrogen-only formulations (often prescribed to women around the age of menopause) increased the risk of stroke, deep vein thrombosis, dementia, and incontinence; the combined therapy also increased breast cancer risk. Two years after the results of the Women's Health Initiative were published, a survey of more than 700 practicing gynecologists"the specialists who prescribe the majority of hormone replacement therapies"in the USA found that almost half did not find the findings of the Women Health Initiative Study convincing. This current study by Adriane Fugh-Berman from Georgetown University Medical Center, Washington D.C., USA, and colleagues, published in this week's PLoS Medicine investigated whether promotional tone could be identified in narrative review articles regarding menopausal hormone therapy.
Although most of the articles were scientifically accurate, common themes in the 50 articles included arguments that clinical trial results should not guide treatment for individuals, and suggestions that the risks associated with hormone therapy have been exaggerated and that the benefits of hormone therapy have been, or will be, proven. Of the ten authors studied, eight were found to have received payment for speaking or consulting on behalf of menopause hormone manufacturers and 30 of 32 articles evaluated as promoting hormone therapy were written by those with such potential financial conflicts of interest. Articles promoting the use of menopausal hormone therapy were more than twice as likely to have been written by authors with potential conflicts of interest as by authors without such conflicts of interest.
The authors say: "There may be a connection between industry funding for research, speaking, or consulting and the publication of promotional pieces on menopausal hormone therapy." They add: ''Health care providers should exercise caution if they choose to read such articles."