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The mortality toll of estrogen avoidance: an analysis of excess deaths among hysterectomized women aged 50 to 59 years.

Abstract

OBJECTIVES

We examined the effect of estrogen avoidance on mortality rates among hysterectomized women aged 50 to 59 years.

METHODS

We derived a formula to relate the excess mortality among hysterectomized women aged 50 to 59 years assigned to placebo in the Women's Health Initiative randomized controlled trial to the entire population of comparable women in the United States, incorporating the decline in estrogen use observed between 2002 and 2011.

RESULTS

Over a 10-year span, starting in 2002, a minimum of 18 601 and as many as 91 610 postmenopausal women died prematurely because of the avoidance of estrogen therapy (ET).

CONCLUSIONS

ET in younger postmenopausal women is associated with a decisive reduction in all-cause mortality, but estrogen use in this population is low and continuing to fall. Our data indicate an associated annual mortality toll in the thousands of women aged 50 to 59 years. Informed discussion between these women and their health care providers about the effects of ET is a matter of considerable urgency.

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  • Authors+Show Affiliations

    ,

    Departments of Obstetrics and Gynecology and Psychiatry, Yale University School of Medicine, New Haven, CT, USA. philip.sarrel@yale.edu

    , ,

    Source

    American journal of public health 103:9 2013 Sep pg 1583-8

    MeSH

    Estrogens
    Female
    Humans
    Hysterectomy
    Middle Aged
    Ovariectomy
    Risk Assessment
    United States

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    23865654

    Citation

    Sarrel, Philip M., et al. "The Mortality Toll of Estrogen Avoidance: an Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years." American Journal of Public Health, vol. 103, no. 9, 2013, pp. 1583-8.
    Sarrel PM, Njike VY, Vinante V, et al. The mortality toll of estrogen avoidance: an analysis of excess deaths among hysterectomized women aged 50 to 59 years. Am J Public Health. 2013;103(9):1583-8.
    Sarrel, P. M., Njike, V. Y., Vinante, V., & Katz, D. L. (2013). The mortality toll of estrogen avoidance: an analysis of excess deaths among hysterectomized women aged 50 to 59 years. American Journal of Public Health, 103(9), pp. 1583-8. doi:10.2105/AJPH.2013.301295.
    Sarrel PM, et al. The Mortality Toll of Estrogen Avoidance: an Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years. Am J Public Health. 2013;103(9):1583-8. PubMed PMID: 23865654.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The mortality toll of estrogen avoidance: an analysis of excess deaths among hysterectomized women aged 50 to 59 years. AU - Sarrel,Philip M, AU - Njike,Valentine Y, AU - Vinante,Valentina, AU - Katz,David L, Y1 - 2013/07/18/ PY - 2013/7/20/entrez PY - 2013/7/20/pubmed PY - 2013/11/14/medline SP - 1583 EP - 8 JF - American journal of public health JO - Am J Public Health VL - 103 IS - 9 N2 - OBJECTIVES: We examined the effect of estrogen avoidance on mortality rates among hysterectomized women aged 50 to 59 years. METHODS: We derived a formula to relate the excess mortality among hysterectomized women aged 50 to 59 years assigned to placebo in the Women's Health Initiative randomized controlled trial to the entire population of comparable women in the United States, incorporating the decline in estrogen use observed between 2002 and 2011. RESULTS: Over a 10-year span, starting in 2002, a minimum of 18 601 and as many as 91 610 postmenopausal women died prematurely because of the avoidance of estrogen therapy (ET). CONCLUSIONS: ET in younger postmenopausal women is associated with a decisive reduction in all-cause mortality, but estrogen use in this population is low and continuing to fall. Our data indicate an associated annual mortality toll in the thousands of women aged 50 to 59 years. Informed discussion between these women and their health care providers about the effects of ET is a matter of considerable urgency. SN - 1541-0048 UR - https://www.unboundmedicine.com/medline/citation/23865654/The_Mortality_Toll_of_Estrogen_Avoidance:_An_Analysis_of_Excess_Deaths_Among_Hysterectomized_Women_Aged_50_to_59_Years_ L2 - http://www.ajph.org/doi/full/10.2105/AJPH.2013.301295?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -