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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

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

Menopausal hormone therapy use in 17 European countries during the last decade
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 - August 4, 2014 Category: Primary Care Authors: Lieveke Ameye, Caroline Antoine, Marianne Paesmans, Evandro de Azambuja, Serge Rozenberg Source Type: research

Menopausal hormone therapy has risks and benefits during the intervention and poststopping phase
This report summarises the previous WHI reports alongside 13 years of follow-up in 81.1% of surviving participants. Some selection bias may have occurred in the postintervention phase due to occurrences in the intervention phase. Methods Women were recruited from 1993 to 1998...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Warren, M. P. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Menopause (including HRT), Ischaemic heart disease, Venous thromboembolism, Pulmonary embolism, Injury Prevention Source Type: research

Cardiovascular benefits of HRT may differ by patient age
Commentary on: Main C, Knight B, Moxham T, et al.. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev 2013;(4):CD002229. Context In early postmenopausal women oestrogen and/or hormone replacement therapy (ERT/HRT) are used to alleviate symptoms and reduce the probability of diseases related to ovarian hormones deprivation. However, in late postmenopausal women the initiation of HRT has a negative risk/benefit balance mainly because of the increased risk of cardiovascular diseases (CVD). Methods Main et al performed a meta-analysis of randomised controlled trials (RCTs...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Rosano, G., Vitale, C. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Contraception, Drugs: obstetrics and gynaecology, Menopause (including HRT), Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology Source Type: research

Hormone Therapy in Women After Heart Transplantation
Conclusions: HT is not associated with poor outcome or adverse effects in female heart transplant patients after age 35 years. However, a larger cohort of patients is necessary to confirm these observations.
Source: Transplantation Proceedings - November 1, 2013 Category: Transplant Surgery Authors: L.C. Kobashigawa, M. Hamilton, M. Rafiei, L. Stern, C.N. Bairey Merz Tags: Thoracic Transplantation Source Type: research

While hormone therapy unlikely harmful in younger postmenopausal women at low CV risk, protective effects cannot be claimed
Commentary on: Schierbeck LL, Rejnmark L, Tofteng CL, et al.. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial. BMJ 2012;345:e6409. Context The last 10 years have clarified the issues regarding postmenopausal hormone therapy (HT) and cardiovascular disease (CVD). Prior to the large, randomised women's health initiative (WHI),1 observational studies had suggested a protective cardiovascular (CV) effect. The WHI showed no benefit, and increased thromboembolic and CV events in women taking HT. The WHI findings have been challenged because of the older age of the...
Source: Evidence-Based Medicine - September 19, 2013 Category: Internal Medicine Authors: Abramson, B. L. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Menopause (including HRT), Ischaemic heart disease, Venous thromboembolism Therapeutics Source Type: research

Higher parity is associated with an increased risk of type‐II diabetes in Chinese women: the Singapore Chinese Health Study
ConclusionsIncreased parity may be a risk factor for type‐II diabetes in Chinese women. More research is needed on lifestyle and physiologic factors that may explain this association.
Source: BJOG: An International Journal of Obstetrics and Gynaecology - June 21, 2013 Category: OBGYN Authors: NT Mueller, NJ Mueller, AO Odegaard, MD Gross, WP Koh, JM Yuan, MA Pereira Tags: Original Article Source Type: research

Hormone therapy not recommended for chronic disease prevention in menopausal women
Commentary on: Nelson HD, Walker M, Zakher B, et al.. Menopausal hormone therapy for the primary prevention of chronic conditions: a systematic review to update the US Preventive Services Task Force recommendations. Ann Intern Med 2012;157:104–13. Context In 2005, the US Preventive Services Task Force (USPSTF) updated its 2002 hormone replacement therapy recommendations, advising against the routine use of oestrogen and progestin (E+P) and unopposed oestrogen (E) to prevent chronic conditions in menopausal women. Menopausal hormone therapy (MHT) had been commonly prescribed to prevent conditions such as cardiovascula...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Wenger, N. K. Tags: Pancreas and biliary tract, Epidemiologic studies, Drugs: cardiovascular system, Dementia, Stroke, Contraception, Drugs: obstetrics and gynaecology, Menopause (including HRT), Ischaemic heart disease, Venous thromboembolism, Memory disorders (psychiatry), Source Type: research

Lessons Learned From the Women's Health Initiative Trials of Menopausal Hormone Therapy.
Abstract We re-evaluate the Women's Health Initiative findings and their implications for clinical practice. Menopausal hormone therapy (HT) was effective for relief of vasomotor symptoms, and the risk of coronary heart disease (CHD) tended to be reduced in women close to menopause compared with the increased risk in women more distant from menopause. In recently menopausal women, short-term absolute risks of stroke and venous thromboembolism were small. Estrogen plus progestin therapy, but not estrogen therapy, increased the risk of breast cancer with a suggestion of greater risk when initiated close to the menop...
Source: Obstetrics and Gynecology - January 1, 2013 Category: OBGYN Authors: Rossouw JE, Manson JE, Kaunitz AM, Anderson GL Tags: Obstet Gynecol Source Type: research

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