The first clinical synthesis conference on hormone replacement therapy: new perspectives for HRT?

After nearly 4 years since the first European Consensus Conference on Menopause was held in Montreux (Switzerland) and 2 years after the European position paper on Hormone Replacement Therapy and the Menopause [1] was published, the first Clinical Synthesis Conference on hormone replacement therapy (HRT) was organised (23–25 June 1999) at the European Institute of Oncology in Milan, Italy. This conference was a combined initiative of the European Institute of Oncology (Prof. P. Boyle, Prof. U. Veronesi), the Harvard School of Public Health (Prof. A.M. Walker), the Italian Instituto Superiore di Sanita (Prof. G. Benagiano), the UK Medical Research Council (Dr G. Radda), as well as The Lancet (Dr R. Horton, Dr D. Sharp). The meeting was open to all experts and specialists in the field of menopause and HRT, to policymakers, and to professional and commercial organisations. The aim of this first clinical synthesis meeting (not to be confused with a consensus meeting) was to discuss and to identify areas of agreement in the use of HRT, using all available scientific proof. Topics for discussion included the effects of HRT on menopausal symptoms, cardiovascular disease, osteoporosis, dementia, and on cancer risk. A selected board of experts was invited to prepare extensive papers on these specific topics. In addition, one or two other specialist in the field prepared a formal discussion on the given lecture. Thereafter, members of the audience were invited to make their own comments on the issue discussed. Finally, the conclusions related to the clinical synthesis statement (which unfortunately was not available at the meeting) were presented by the members of the clinical synthesis panel at a public discussion on the afternoon of 25 June. Recently, The Lancet published the clinical synthesis statement on HRT [2]. The present report reflects an impression of the issues that were discussed during the meeting, presented and worded in a personal way by the authors.