Deschênes et al.
1 reported remarkable news in their study, “Postmenopausal Hormone Therapy Increases Retinal Blood Flow and Protects the Retinal Nerve Fiber Layer,” which appeared in the May 2010 issue of the journal. For those women who are using hormone replacement therapy (HRT) for specific indications, such as vasomotor instability, this serendipitous benefit can provide additional reassurance that the holistic effect of HRT improves the quality of life for many women. Three to four decades ago, the chronic hypoestrogenemia of menopause was considered a pathologic state. Our sophisticated evidence-based clinical trials and basic science evaluation of estrogen receptor function are giving us an amazing understanding of the role of eu-estrogenemia.
2,3
A large number of menopausal women are following the recommendation of “lowest dose for the shortest duration,” to treat vasomotor instability and urogenital atrophy. Also, millions of women abruptly stopped HRT in 2002 on the recommendations of Jacques Rossouw, the head of Women's Health Initiative (WHI) at the National Institutes of Health (NIH). We have named this epidemiologic phenomenon, Rossouw's cohort.
4 As clinical gynecologists and fellow ophthalmologists, we have another three decades in which we will be observing our patients' health, well-being, and quality of life. We warily consider what suboptimal retinal blood flow will mean for our patients who are chronically hypoestrogenemic.