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Postmenopausal Hormone Therapy and the Risks of Coronary Heart Disease, Breast Cancer, and Stroke
Semin Reprod Med 2014; 32: 419-425DOI: 10.1055/s-0034-1384624The principal findings are briefly reviewed from the Women's Health Initiative trials of the most commonly used postmenopausal hormone regimens in the United States—conjugated equine estrogens and these same estrogens plus medroxyprogesterone acetate. A more detailed review is presented for three major clinical outcomes: coronary heart disease (CHD), the primary trial outcome for which a major benefit was hypothesized; invasive breast cancer, the primary safety outcome for which some adverse effect was expected; and stroke which surfaced as an important adverse...
Source: Seminars in Reproductive Medicine - October 16, 2014 Category: Reproduction Medicine Authors: Prentice, Ross L. Source Type: research

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

Current recommendations: what is the clinician to do?
Menopausal hormone therapy (HT) has complex biologic effects but continues to have an important clinical role in the management of vasomotor and other menopausal symptoms. The rational use of menopausal HT requires balancing the potential benefits and risks of treatment. Findings from the Women's Health Initiative (WHI) and other randomized clinical trials have helped to clarify the benefits and risks of HT and have provided insights to improve decision making. Several clinical characteristics have utility in identifying women for whom benefits of HT are likely to outweigh the risks. Age and time since menopause are strong...
Source: Fertility and Sterility - March 31, 2014 Category: Reproduction Medicine Authors: JoAnn E. Manson Tags: Views and reviews Source Type: research

Women's Health Initiative estrogen plus progestin clinical trial: a study that does not allow establishing relevant clinical risks
Conclusions: The differences in RMST for the outcomes of the WHI study are too small to establish clinical risks related to hormone therapy use.
Source: Menopause - December 1, 2015 Category: OBGYN Tags: Original Articles Source Type: research

Menopausal hormone therapy and ovarian cancer: putting risk into perspective
The wide use of menopausal hormone therapy (MHT) rapidly declined a decade ago after the results of the Women's Health Initiative (WHI) showed that women treated with conjugated equine estrogens plus medroxyprogesterone acetate had an increased risk of breast cancer, coronary heart disease, stroke, and pulmonary embolism [1]. Increased ovarian cancer risk was not reported in the randomized WHI intervention trial nor in the extended poststopping phases of the study [2].
Source: Maturitas - February 26, 2015 Category: Primary Care Authors: Faustino R. Pérez-López, Margaret Rees Source Type: research

Reprint of “Use of medroxyprogesterone acetate for hormone therapy in postmenopausal women: Is it safe?”
Publication date: Available online 19 August 2015 Source:The Journal of Steroid Biochemistry and Molecular Biology Author(s): Frank Z. Stanczyk, Bhagu R. Bhavnani Medroxyprogesterone acetate (MPA) has been in clinical use for over 30 years, and was generally considered to be safe until the results of long-term studies of postmenopausal hormone therapy (HT) using treatment with conjugated equine estrogens (CEE) combined with MPA and CEE alone suggested that MPA, and perhaps other progestogens, may play a role in the increased risk of breast cancer and cardiovascular diseases. This review examines critically the safety o...
Source: The Journal of Steroid Biochemistry and Molecular Biology - August 21, 2015 Category: Biochemistry Source Type: research

The evolving role of oral hormonal therapies and review of conjugated estrogens/bazedoxifene for the management of menopausal symptoms.
Authors: Parish SJ, Gillespie JA Abstract This review describes the evolving role of oral hormone therapy (HT) for treating menopausal symptoms and preventing osteoporosis, focusing on conjugated estrogens/bazedoxifene (CE/BZA). Estrogens alleviate hot flushes and prevent bone loss associated with menopause. In nonhysterectomized women, a progestin should be added to estrogens to reduce the risk of endometrial cancer. Use of HT declined since the Women's Health Initiative (WHI) studies showed that HT does not prevent coronary heart disease (CHD) and that conjugated estrogens/medroxyprogesterone acetate increased th...
Source: Postgraduate Medicine - February 1, 2017 Category: Internal Medicine Tags: Postgrad Med Source Type: research

In Defense of Progesterone: A Review of the Literature.
Conclusions • Physicians should have no hesitation prescribing natural progesterone. The evidence is clear that progesterone does not cause breast cancer. Indeed, progesterone is protective and preventative of breast cancer. PMID: 29055286 [PubMed - as supplied by publisher]
Source: Alternative Therapies in Health and Medicine - October 21, 2017 Category: Complementary Medicine Authors: Lieberman A, Curtis L Tags: Altern Ther Health Med Source Type: research

Randomized Trial Evaluation of Benefits and Risks of Menopausal Hormone Therapy Among Women Aged 50-59.
Abstract The health benefits and risks of menopausal hormone therapy among women aged 50-59 years are examined in the Women's Health Initiative randomized, placebo-controlled trials using long-term follow-up data and a parsimonious statistical model that leverages data from older participants to increase precision. These trials enrolled 27,347 healthy post-menopausal women aged 50-79 at 40 U.S. clinical centers during 1993-1998, including 10,739 post-hysterectomy participants in a trial of conjugated equine estrogens, and 16,608 participants with uterus in the trial of these estrogens plus medroxyprogesterone acet...
Source: Am J Epidemiol - October 7, 2020 Category: Epidemiology Authors: Prentice RL, Aragaki AK, Chlebowski RT, Rossouw JE, Anderson GL, Stefanick ML, Wactawski-Wende J, Kuller LH, Wallace R, Johnson KC, Shadyab AH, Gass M, Manson JAE Tags: Am J Epidemiol Source Type: research