Deborah Grady, MD, MPH
Staff Physician, Medical Service, SFVAMC
Professor of Epidemiology and Medicine, UCSF
Email: deborah.grady@ucsf.edu
Risks and Benefits of Postmenopausal Hormone Therapy
Dr. Grady is one of the world's leading experts on the risks and benefits of postmenopausal hormone therapy. In 1992, she developed evidence-based guidelines for use of postmenopausal hormone therapy for the American College of Physicians. With minor changes, these guidelines were adopted by the American College of Family Practice, the American Heart Association and the US Preventive Services Task Force. However, Dr. Grady and others felt that a randomized trial was imperative. She subsequently played a lead role in designing and conducting the Heart and Estrogen/progestin Replacement Study (HERS), the first randomized trial of the effect of estrogen therapy on risk for heart disease events. Surprisingly, this 20-center 7-year trial among 2,763 postmenopausal women with coronary disease showed no benefit of estrogen plus progestin therapy, and a 3-fold increased risk of blood clots. Dr. Grady has also investigated the effect of postmenopausal hormone therapy on cognition, dementia, and a variety of other clinical outcomes, and written extensively on the rational clinical use of hormones.
Grady D, Cauley JA, Geiger MJ, Kornitzer M, Mosca L, Collins P, Wenger NK, Song J, Mershon J, Barrett-Connor E; Raloxifene Use for The Heart Trial Investigators. 2008. Reduced incidence of invasive breast cancer with raloxifene among women at increased coronary risk. J Natl Cancer Inst 100(12):854-61.
Ensrud KE, Stone KL, Blackwell TL, Sawaya GF, Tagliaferri M, Diem SJ, Grady D. 2008. Frequency and severity of hot flashes and sleep disturbance in postmenopausal women with hot flashes. Menopause (Epub ahead of print).
