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HRT optimization, using transdermal estradiol plus micronized progesterone, a safer HRT.
Abstract ABSTRACT Hormone replacement therapy (HRT) remains the gold standard for treatment of climacteric symptoms in menopausal women; it is relatively safe in healthy subjects for at least 5 years, provided it had been initiated before the age of 60 years and/or within 10 years from menopause. Estrogen probably adds some cardioprotection, that can, however, be obscured by progestogens, especially medroxyprogesterone acetate (MPA). Oral HRT is associated with an increased risk of venous thromboembolism (VTE), gallbladder disease and possibly stroke. The increased occurrence of all these events can be prevented b...
Source: Climacteric - July 19, 2013 Category: Geriatrics Authors: L'hermite M Tags: Climacteric Source Type: research

Managing menopause.
Authors: Reid R, Abramson BL, Blake J, Desindes S, Dodin S, Johnston S, Rowe T, Sodhi N, Wilks P, Wolfman W, Menopause and Osteoporosis Working Group, Fortier M, Reid R, Abramson BL, Blake J, Desindes S, Dodin S, Graves L, Guthrie B, Khan A, Johnston S, Rowe T, Sodhi N, Wilks P, Wolfman W Abstract OBJECTIVE: To provide updated guidelines for health care providers on the management of menopause in asymptomatic healthy women as well as in women presenting with vasomotor or urogenital symptoms and on considerations related to cardiovascular disease, breast cancer, urogynaecology, and sexuality. OUTCOMES: Lifestyle...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - December 2, 2014 Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research

Can HRT in early menopause cut heart disease risk?
ConclusionThis double-blind RCT found that women taking HRT less than six years after the menopause had slower artery wall thickening than those taking a placebo. This represented the main measure of atherosclerosis progression tested; other measures showed no difference, so the results were not as conclusive as they could have been. Women taking HRT 10 or more years after menopause also showed no difference in atherosclerosis progression compared with a placebo, further complicating the picture.An important limitation of this study is the lack of a patient relevant endpoint, such as cardiovascular events or mortality. Pre...
Source: NHS News Feed - April 1, 2016 Category: Consumer Health News Tags: Heart/lungs Medication Source Type: news

Sex Differences in Sex Hormone Profiles and Prediction of Consciousness Recovery After Severe Traumatic Brain Injury
Conclusion: These findings indicate that TBI differentially affects the levels of sex-steroid hormones in men and women patients. Plasma levels of testosterone could be a good candidate blood marker to predict recovery from unconsciousness after sTBI for male patients. Introduction Traumatic brain injury (TBI) is a major cause of death and disability worldwide and is increasing in incidence (1). Patients with acute severe TBI (sTBI) often develop severe disorders of consciousness, i.e., coma, minimally conscious state or vegetative state. Although many patients may regain consciousness during the 1-month post-TBI p...
Source: Frontiers in Endocrinology - April 25, 2019 Category: Endocrinology Source Type: research

In assessing risk of hormone therapy for menopause, dose — not form — matters
FINDINGSWhen it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered — taking a pill versus wearing a patch on one’s skin — doesn’t affect risk or benefit, researchers at UCLA and elsewhere have found. But with the commonly used conjugated equine estrogen, plus progestogen, the dosage does. Higher doses, especially over time, are associated with greater risk of problems, including heart disease and some types of cancer, especially among obese women.BACKGROUNDThe Women ’s Health Initiative established the potential of estrogen therapy to increase or decrease the risk of strok...
Source: UCLA Newsroom: Health Sciences - July 27, 2017 Category: Universities & Medical Training Source Type: news

Bioidentical hormones for women with vasomotor symptoms.
CONCLUSIONS: There was low to moderate quality evidence that BHT in various forms and doses is more effective than placebo for treating moderate to severe menopausal hot flushes. There was low to moderate quality evidence of higher rates of adverse effects such as headache, vaginal bleeding, breast tenderness and skin reactions in the BHT group. There was some evidence to suggest that higher doses of BHT are associated with greater effectiveness but also with higher risk of adverse effects. Although all the included studies used unopposed estrogen, it is recommended best practice to use progestogen therapy in women with a ...
Source: Cochrane Database of Systematic Reviews - July 31, 2016 Category: Journals (General) Authors: Gaudard AM, Silva de Souza S, Puga ME, Marjoribanks J, da Silva EM, Torloni MR Tags: Cochrane Database Syst Rev Source Type: research

Custom-compounded bioidentical hormone therapy: why so popular despite potential harm? The case against routine use.
Abstract Wide rejection of conventional hormone therapy (HT) after the initial publication of the Women's Health Initiative (WHI) led to unjustified use of custom-compounded bioidentical hormones. In the USA, it became an unregulated drug manufacturer industry in disguise, without proper control and making false claims and misleading advertisements. Manufacturing quality is not ensured. Unspecific harm from compounding has occurred on a large scale, such as deaths from infected products and end-stage renal failure plus carcinoma due to confusion between different Chinese herbs. Oral estrogens increase venous throm...
Source: Climacteric - May 18, 2017 Category: Geriatrics Authors: L'Hermite M Tags: Climacteric Source Type: research

Comparison of clinical outcomes among users of oral and transdermal estrogen therapy in the Women's Health Initiative Observational Study
Conclusions: The summary index of risks versus benefits was similar for oral CEE versus oral or transdermal E2-containing regimens. CEE + P containing less than 0.625 mg/d of CEE (vs 0.625 mg/d) for less than 5 years appeared safer.
Source: Menopause - September 23, 2017 Category: OBGYN Tags: Original Articles Source Type: research