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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

7 Tips To Lower Diabetes Risk in Menopause During the Holidays
By now, most people have been to a holiday party or two. Lots of food, lots of eggnog and other carb laden alcoholic beverages, and lots of grazing all day long on all the boxes of candy friends and business acquaintances sent to us. It's easy to gain the five pounds most people gain during the holidays, and in the process, raise your blood sugar or glucose levels too high. That's your body letting you know you have prediabetes (higher than normal but still below diabetes levels) or diabetes, and unless you take action soon, your body won't like it. Diabetes silently sneaks up on you and if untreated, slowly weakens your ...
Source: Healthy Living - The Huffington Post - December 23, 2016 Category: Consumer Health News Source Type: news

Withdrawal of hormone therapy and increased risk of cardiovascular disease.
Abstract Many menopause specialists follow the principle of prescribing postmenopausal hormone therapy (HT) for the shortest duration needed, in order to decrease the risk of some related serious adverse effects, such as breast cancer. Based on several large studies, it seems, however, that withdrawal of HT may be associated with immediate, though small increased risk of coronary heart disease and stroke. Cessation of HT correlates with increased risk of fractures as well. This information should be relayed to hormone users while discussing the continuation of HT with their health-care provider, but, since the pot...
Source: Climacteric - April 13, 2016 Category: Geriatrics Authors: Pines A Tags: Climacteric 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

Vaginal estradiol use and the risk for cardiovascular mortality
STUDY QUESTION Does the use of post-menopausal vaginal estradiol (VE) affect the mortality risk for coronary heart disease (CHD) and stroke. SUMMARY ANSWER The use of VE reduces the risk for cardiovascular mortality. WHAT IS KNOWN ALREADY A growing number of women use VE for post-menopausal genitourinary symptoms. Although this therapy is intended to have only local effects, estrogen is absorbed into the blood circulation and thus VE use may also have systemic effects. STUDY DESIGN, SIZE, DURATION We studied a nationwide cohort in Finland 1994–2009 during which post-menopausal women (n = 195 756) initiated the use...
Source: Human Reproduction - March 15, 2016 Category: Reproduction Medicine Authors: Mikkola, T. S., Tuomikoski, P., Lyytinen, H., Korhonen, P., Hoti, F., Vattulainen, P., Gissler, M., Ylikorkala, O. Tags: Puberty, Aging and HRT Source Type: research

Hormone use and stroke
Publication date: Available online 14 March 2016 Source:Apollo Medicine Author(s): Pushpendra Nath Renjen, Dinesh M. Chaudhari, Mahir Meman Strokes are an important cause of disability and death among older women. Because many women use hormone therapy for the control of perimenopausal symptoms and to prevent osteoporosis after menopause, establishing whether such therapy has other health effects is of considerable clinical importance. Overall, 55% of strokes occur in women, and women account for nearly 60% of all stroke-related deaths. Women appear to be protected from heart disease and stroke before menopause. This ...
Source: Apollo Medicine - March 14, 2016 Category: Journals (General) Source Type: research

Cochrane corner: oral hormone therapy and cardiovascular outcomes in post-menopausal women
Introduction Hormone therapy (HT) is commonly prescribed for the relief of climacteric symptoms in post-menopausal women; 54% (620490) of women enrolled in the Million Women Study1 in the UK (mean age 56 years) have tried it and 31% (358252) use it. Observational studies have shown oral HT is associated with lower rates of cardiovascular disease in post-menopausal women2; however randomised controlled trials (RCTs) have presented mixed results. The 2002 publication of the Women's Health Initiative I (WHI I) reported an association between combined oestrogen and progestin use and increased rates of both coronary heart...
Source: Heart - December 11, 2015 Category: Cardiology Authors: Boardman, H., Hartley, L., Eisinga, A., Main, C., Figuls, M. R. I. Tags: Drugs: cardiovascular system, Cochrane Corner, Acute coronary syndromes, Venous thromboembolism, Epidemiology Editorials 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

Estradiol-based postmenopausal hormone therapy and risk of cardiovascular and all-cause mortality
Conclusions: In absolute terms, the risk reductions mean 19 fewer CHD deaths and 7 fewer stroke deaths per 1,000 women using any HT for at least 10 years.
Source: Menopause - August 28, 2015 Category: OBGYN Tags: Original Articles Source Type: research

Long-term menopausal hormone therapy and health consequences - how to choose sides?
Abstract There is no debate any more on the good safety profile of postmenopausal hormone therapy (HT) in healthy perimenopausal and early postmenopausal women, but there are still many open issues related to the consequences of long-term HT, especially in older women. A recent Cochrane meta-analysis showed that women who started HT less than 10 years after the menopause had lower mortality and coronary heart disease (CHD), but more venous thromboembolism (DVT). However, in those who started treatment more than 10 years after the menopause, there was high-quality evidence that it had little effect on death or CHD ...
Source: Climacteric - May 11, 2015 Category: Geriatrics Authors: Pines A, Shapiro S Tags: Climacteric Source Type: research

Menopausal hormone therapy use in 17 European countries during the last decade
Introduction: The first ‘Women's Health Initiative’ (WHI) randomised controlled trial assessed use of continuous combined menopausal hormone therapy (cc-MHT). It was prematurely stopped because of an increased invasive breast cancer (BC), coronary heart disease (CHD), stroke and pulmonary embolism risk. Consequently, scientific societies recommended use of MHT at the lowest effective dose for the shortest duration. As a result, a sharp decline in MHT use occurred worldwide.
Source: Maturitas - April 21, 2015 Category: Primary Care Authors: Lieveke Ameye, Caroline Antoine, Marianne Paesmans, Evandro de Azambuja, Serge Rozenberg Tags: O44 Source Type: research

More Evidence That Hormone Therapy Might Not Help Women's Hearts
Review also found raised risk of stroke for some, although timing of use may be a key factor Source: HealthDay Related MedlinePlus Pages: Heart Disease in Women, Hormone Replacement Therapy, Women's Health
Source: MedlinePlus Health News - March 10, 2015 Category: Consumer Health News Source Type: news

HRT review finds increased risk of blood clots and stroke
Conclusion This updated Cochrane review has found that oral HRT increases risk of stroke and blood clots, and does not appear to reduce overall risk of cardiovascular disease or death during follow-up. More exploratory analyses suggested that HRT might reduce risk of death from heart disease or non-fatal heart attack if it was started within 10 years of menopause, but this finding needs further confirmation. The review was carried out using robust methods and the trials were of good quality. Its findings are in line with the previous version of the review, and also with other reviews. There are some points to note: Thi...
Source: NHS News Feed - March 10, 2015 Category: Consumer Health News Tags: Heart/lungs Medication Source Type: news

Hormone therapy for preventing cardiovascular disease in post-menopausal women.
CONCLUSIONS: Our review findings provide strong evidence that treatment with hormone therapy in post-menopausal women overall, for either primary or secondary prevention of cardiovascular disease events has little if any benefit and causes an increase in the risk of stroke and venous thromboembolic events. PMID: 25754617 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 10, 2015 Category: Journals (General) Authors: Boardman HM, Hartley L, Eisinga A, Main C, Roqué I Figuls M, Bonfill Cosp X, Gabriel Sanchez R, Knight B Tags: Cochrane Database Syst Rev 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

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