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Hormone therapy in menopausal women with fibroids: is it safe?
Menopause is an important transition in the life of women. It has been estimated that by the year 2030, worldwide 1.2 billion women will be menopausal. The most bothersome symptoms of menopause are believed to be due to declines in estrogen levels in postmenopausal women. Thus, hormone therapy is an effective treatment option for menopausal women, although prolonged use of hormone therapy is associated with a slightly increased risk of breast cancer, thromboembolism, and stroke. A literature search for studies evaluating the effects of hormone therapy in menopausal women with asymptomatic fibroids demonstrated variable eff...
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Personal Perspective 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

Long-term hormone therapy for perimenopausal and postmenopausal women.
CONCLUSIONS: Women with intolerable menopausal symptoms may wish to weigh the benefits of symptom relief against the small absolute risk of harm arising from short-term use of low-dose HT, provided they do not have specific contraindications. HT may be unsuitable for some women, including those at increased risk of cardiovascular disease, increased risk of thromboembolic disease (such as those with obesity or a history of venous thrombosis) or increased risk of some types of cancer (such as breast cancer, in women with a uterus). The risk of endometrial cancer among women with a uterus taking oestrogen-only HT is well docu...
Source: Cochrane Database of Systematic Reviews - January 16, 2017 Category: Journals (General) Authors: Marjoribanks J, Farquhar C, Roberts H, Lethaby A, Lee J Tags: Cochrane Database Syst Rev Source Type: research

Prevalence of menopausal symptoms among mid-life women: findings from electronic medical records
Conclusion: Our findings provide recent data on the types of menopausal symptoms experienced by mid-life women prescribed HT. Electronic medical records may be a rich source of data for future studies of menopausal symptoms in this population.
Source: BMC Women's Health - August 13, 2015 Category: OBGYN Authors: Matthew SussmanJeffrey TrocioCraig BestSebastian MirkinAndrew BushmakinRobert YoodMark FriedmanJoseph MenzinMichael Louie Source Type: research

Hormone therapy and venous thromboembolism among postmenopausal women
Despite a decrease in postmenopausal hormone therapy (HT) use during the last decade, many women are still prescribed this treatment which remains the most effective to counteract climacteric symptoms. However, HT increases the risk of breast cancer, stroke and venous thromboembolism (VTE) which represents the major harmful effect of short-term duration use. Nevertheless, this benefit/risk ratio has been established among women using oral estrogens alone or combined with a specific progestogen and cannot be necessary extrapolated to other HT.
Source: Maturitas - April 21, 2015 Category: Primary Care Authors: Marianne Canonico Tags: INV32 Source Type: research

HRT increases ovarian cancer risk by small amount
Conclusion This systematic review and meta-analysis showed that ovarian cancer risk was significantly increased in current HRT users, even in those with less than five years of HRT use (the average was three years). In ex-users, risks decreased the longer ago HRT use had stopped, but risks during the first few years after stopping remained significant. Furthermore, about a decade after stopping, long-duration hormone therapy use (average nine years of HRT use), there still seemed to be a small excess risk. The review has a few limitations, however. The main one is that the review was heavily influenced by just two of t...
Source: NHS News Feed - February 13, 2015 Category: Consumer Health News Tags: Cancer Medication Older people Source Type: news

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

FDA Approval of Paroxetine for Menopausal Hot Flushes
ABSTRACT: In June 2013, the Food and Drug Administration (FDA) approved paroxetine (Brisdelle, Noven) for the treatment of moderate to severe hot flushes (vasomotor symptoms) associated with menopause. Brisdelle is the only nonhormonal treatment approved by the FDA for this indication. Prior to approval of Brisdelle, FDA-approved treatments for hot flashes were hormones containing either estrogen alone or estrogen plus a progestin. Hormonal therapy is highly effective for treating vasomotor symptoms. However, the use of hormonal therapy dropped substantially after initial findings of the Women’s Health Initiative randomi...
Source: Obstetrical and Gynecological Survey - October 1, 2014 Category: OBGYN Tags: Gynecology: Office Gynecology 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

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