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Invited Commentary: Hormone therapy risks and benefits--The Women's Health Initiative findings and the postmenopausal estrogen timing hypothesis.
Am J Epidemiol. 2009 Jul 01; 170(1):24-8.AJ

Abstract

Worldwide evidence on menopausal hormone therapy shows that it does not reduce coronary heart disease (CHD) risk and that it increases the risks of breast cancer, stroke, and venous thromboembolism. These risks are not offset by reductions in hip fracture risk. Consequently, the Food and Drug Administration and other drug regulatory authorities agree that hormone therapy should be used chiefly for short-term relief of menopausal symptoms. Continuing speculation relates to the "postmenopausal estrogen timing" hypothesis, which proposes that hormone therapy initiated soon after menopause will prevent CHD while therapy started later will have a null or adverse effect. The detailed analyses of Women's Health Initiative data reviewed here specifically address the timing hypothesis. For hormone therapy initiated soon after menopause versus therapy started later, the findings demonstrate 1) similar null or adverse effects on CHD risk; 2) similar adverse effects on the risks of stroke and venous thrombosis; and 3) possibly greater adverse effects on breast cancer risk. Therefore, Women's Health Initiative data do not support the hypothesis of favorable effects in women starting hormone therapy soon after menopause. Hence, the overall trial findings, including net harm for combined estrogen-progestin and the lack of a net benefit for estrogen-only therapy, also apply to women initiating hormone therapy soon after menopause.

Authors

No affiliation info availableNo affiliation info available

Pub Type(s)

Comment
Editorial

Language

eng

PubMed ID

19468078

Citation

Banks, Emily, and Karen Canfell. "Invited Commentary: Hormone Therapy Risks and benefits--The Women's Health Initiative Findings and the Postmenopausal Estrogen Timing Hypothesis." American Journal of Epidemiology, vol. 170, no. 1, 2009, pp. 24-8.
Banks E, Canfell K. Invited Commentary: Hormone therapy risks and benefits--The Women's Health Initiative findings and the postmenopausal estrogen timing hypothesis. Am J Epidemiol. 2009;170(1):24-8.
Banks, E., & Canfell, K. (2009). Invited Commentary: Hormone therapy risks and benefits--The Women's Health Initiative findings and the postmenopausal estrogen timing hypothesis. American Journal of Epidemiology, 170(1), 24-8. https://doi.org/10.1093/aje/kwp113
Banks E, Canfell K. Invited Commentary: Hormone Therapy Risks and benefits--The Women's Health Initiative Findings and the Postmenopausal Estrogen Timing Hypothesis. Am J Epidemiol. 2009 Jul 1;170(1):24-8. PubMed PMID: 19468078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Invited Commentary: Hormone therapy risks and benefits--The Women's Health Initiative findings and the postmenopausal estrogen timing hypothesis. AU - Banks,Emily, AU - Canfell,Karen, Y1 - 2009/05/25/ PY - 2009/5/27/entrez PY - 2009/5/27/pubmed PY - 2009/7/17/medline SP - 24 EP - 8 JF - American journal of epidemiology JO - Am J Epidemiol VL - 170 IS - 1 N2 - Worldwide evidence on menopausal hormone therapy shows that it does not reduce coronary heart disease (CHD) risk and that it increases the risks of breast cancer, stroke, and venous thromboembolism. These risks are not offset by reductions in hip fracture risk. Consequently, the Food and Drug Administration and other drug regulatory authorities agree that hormone therapy should be used chiefly for short-term relief of menopausal symptoms. Continuing speculation relates to the "postmenopausal estrogen timing" hypothesis, which proposes that hormone therapy initiated soon after menopause will prevent CHD while therapy started later will have a null or adverse effect. The detailed analyses of Women's Health Initiative data reviewed here specifically address the timing hypothesis. For hormone therapy initiated soon after menopause versus therapy started later, the findings demonstrate 1) similar null or adverse effects on CHD risk; 2) similar adverse effects on the risks of stroke and venous thrombosis; and 3) possibly greater adverse effects on breast cancer risk. Therefore, Women's Health Initiative data do not support the hypothesis of favorable effects in women starting hormone therapy soon after menopause. Hence, the overall trial findings, including net harm for combined estrogen-progestin and the lack of a net benefit for estrogen-only therapy, also apply to women initiating hormone therapy soon after menopause. SN - 1476-6256 UR - https://www.unboundmedicine.com/medline/citation/19468078/Invited_Commentary:_Hormone_therapy_risks_and_benefits__The_Women's_Health_Initiative_findings_and_the_postmenopausal_estrogen_timing_hypothesis_ DB - PRIME DP - Unbound Medicine ER -