Concerns Regarding Hearing Loss and Cognitive Outcomes—Reply

Abstract

The number of patients that use OCs may indeed be underestimated, as suggested by Yang et al. Information on the discontinuation of HRT and the reasons thereof could not be retrieved from the database. We are aware that the medical indications for the intake of OCs and HRT may be different, as pointed out by Yang et al, and the indications, dosage and treatment duration are important factors when discussing the effects of exogenous estrogen.We appreciate the valuable comments included in the letters. We see great value in the results from clinical (realworld) data studies in spite of the discussed limitations. We agree with Lin et al that the further improvement of data quantity and quality included in large databases is required to perform robust analyses, from which treatment recommendations can be concluded.