[Estrogen treatment in climacteric and postmenopause after 2002. Can it still be prescribed?].
Preliminary results of the American study called Women's Health Initiative starting in July 2002, showed an increase in some health risks, such as coronary disease, stroke, invasive breast cancer and dementia in 2003, in postmenopausal users of replacement hormonal therapy (HRT) with conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA). These results were opposed to those found in many observational studies in previous years. Although some benefits like significant reduction in number of osteoporotic fractures were demonstrated too, these results caused an enormous change in medical criteria for prescription and time of usage of HRT during the climacteric and postmenopausal periods in the whole world. The publication of complementary information in subsequent years to date, related to other sections or branches of Women's Health Initiative, such as only-estrogens users, which showed no increase of the above mentioned results, confirm the importance of continuing analysis of Women's Health Initiative results, as well as the need to do more research about HRT, with the purpose to get a better understanding about risks and benefits. This paper is a review of the most important results of Women's Health Initiative published to date, with comments about the hypothesis and possibilities to explain them, with the purpose of spreading in a realistic way the state of knowledge in the usage of HRT and increase the information of family physicians in Instituto Mexicano del Seguro Social, who are the first contact for medical care in these periods of their lives and help them to take clinical decisions.
Unidad de Salud Pública, Instituto Mexicano del Seguro Social. Viteliov@aol.com
Vitelio
V
Velasco-Murillo
D002979:Climacteric / Q000187:drug effects*; D002986:Clinical Trials as Topic; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D017698:Postmenopause / Q000187:drug effects; D016387:Women's Health