The rise and fall of menopausal hormone therapy.
Clinical trials show that hormone therapy (HT) is an effective treatment for vasomotor symptoms and vaginal dryness. HT improves other symptoms including sleep and quality of life in women who have menopause symptoms. In the Women's Health Initiative controlled clinical trials, both estrogen therapy (ET) and estrogen plus progestin therapy (EPT) reduced fracture risk, neither reduced the risk of heart disease, and both increased the risk of stroke, deep vein thrombosis, and dementia. EPT, but not ET, increased breast cancer risk and reduced colon cancer risk. Differences between EPT and ET may reflect chance, baseline differences between the EPT and ET cohorts, or a progestin effect. Studies of younger women and lower HT doses with intermediate endpoints are beginning.
Barrett-Connor
Elizabeth
E
Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, 92093-0607, USA. ebarrettconnor@ucsd.edu
Grady
Deborah
D
Stefanick
Marcia L
ML
D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000139:chemically induced / Q000453:epidemiology; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D003704:Dementia / Q000139:chemically induced / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends; D019317:Evidence-Based Medicine; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology / Q000517:prevention & control; D011634:Public Health; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D020521:Stroke / Q000139:chemically induced / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014486:United States Food and Drug Administration; D020246:Venous Thrombosis / Q000139:chemically induced / Q000453:epidemiology; D016387:Women's Health