Postmenopausal estrogen therapy and selected (less-often-considered) disease outcomes.
OBJECTIVE
To review the association between postmenopausal estrogen therapy and chronic conditions not usually considered in risk-benefit reviews.


METHODS
Ten-year literature review (1989-1998) of case series and epidemiologic studies with risk estimates and 95% confidence intervals.


RESULTS
Osteoarthritis and rheumatoid arthritis, the most extensively studied conditions, show no consistent association with hormone therapy. Two studies of systemic lupus erythematosus show a nearly three-fold increased risk apparent after 2 or more years of hormone therapy. Single studies suggest an increased risk of pancreatitis, asthma, and Raynaud's syndrome. Evidence for a reduced risk of diabetes mellitus is not compelling. Cataracts and migraine are either increased or decreased by hormone therapy. Among the associations considered here, only an increased risk of gallbladder disease and venous thromboembolic disease have been confirmed in clinical trials of hormone replacement therapy.


CONCLUSIONS
Further studies are needed.
Barrett-Connor
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Department of Family and Preventive Medicine, University of California, San Diego, USA.
D000368:Aged; D001168:Arthritis / Q000209:etiology; D001249:Asthma / Q000209:etiology; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003920:Diabetes Mellitus / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000209:etiology; D008875:Middle Aged; D008881:Migraine Disorders / Q000209:etiology; D017698:Postmenopause / Q000502:physiology*; D011379:Prognosis; D011928:Raynaud Disease / Q000209:etiology; D018570:Risk Assessment; D013923:Thromboembolism / Q000209:etiology; D016896:Treatment Outcome; D014481:United States; D014552:Urinary Tract Infections / Q000209:etiology