[Preventing of postmenopausal osteoporosis by hormone replacement therapy? Is the risk acceptable?].
Over the past two decades, multiple observational studies have suggested that hormone replacement therapy (HRT) reduced the risk of fracture, increased the quality of life and protected against the cardiovascular disease. HRT was often recommended, on the basis of this evidence, for that indications. But these recommendations were based entirely on observational evidence, which can sometimes be misleading. In the early 1990, several large randomized studies were initiated. The largest of these trials, the Women Health Initiative (WHI) was stopped prematurely last summer (only the group with estrogen plus progestin) because the disadvantages outweighted the advantages of treatment. The conclusions of that study were largely debated in the press and destabilised more than one patient or doctor. The Swiss menopausal society published some directive to precise the indications of HRT.
Wirthner
D
D
Département de gynécologie et obstétrique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne.
Cornuz
J
J
Lamy
O
O
D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D002979:Climacteric; D003110:Colonic Neoplasms / Q000453:epidemiology; D016889:Endometrial Neoplasms / Q000453:epidemiology; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D007044:Hysterectomy; D008525:Medroxyprogesterone / Q000008:administration & dosage; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D010051:Ovarian Neoplasms / Q000453:epidemiology; D010919:Placebos; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors
D004966:Estrogens, Conjugated (USP); D010919:Placebos; D008525:Medroxyprogesterone