Estrogen-Progestin Hormone Replacement Therapy: Evaluation of Epidemiological Studies

Recently it was estimated that about one-third of postmenopausal British women aged 50-64 years currently uses hormone replacement therapy (HRT) for treatment of climacteric symptoms and for other medical reasons. To reduce an excess risk of endometrial cancer induced by oestrogens, modern HRT regimens contain either sequential or continuous progestogens. The protective effect of parity and oral contraceptive use observed in the majority of epidemiological studies on epithelial ovarian cancer (EOC) suggest that hormonal factors are likely to operate in ovarian carcinogenesis. However, the studies where HRT was examined in relation to the risk of EOC have reported conflicting results. The objective of this epidemiological review is to evaluate the risk of EOC in relation to the use of HRT, with particular focus on the few studies where oestrogens and progestogens in HRT were assessed separately. Further, the findings regarding HRT and EOC risk will be discussed in the context of available aetiological hypotheses. Finally, any clinical implications are commented upon.

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Post-Menopausal Hormone Replacement Therapy and Stroke Risk

Cephalalgia ◽

10.1046/j.1468-2982.2000.00043.x ◽

2000 ◽

Vol 20 (3) ◽

pp. 208-213 ◽

Cited By ~ 11

Author(s):

S J Kittner ◽

M-G Bousser

Keyword(s):

Hormone Replacement Therapy ◽

Replacement Therapy ◽

Observational Studies ◽

Animal Studies ◽

Stroke Risk ◽

Hormone Replacement ◽

Epidemiological Studies ◽

Post Menopausal ◽

Relationship Of ◽

The Relationship

This paper will review available data bearing on the relationship of post-menopausal hormone replacement therapy to the risk of first or recurrent ischaemic stroke. Although experimental data from both human and animal studies will be briefly mentioned, the bulk of evidence is from observational epidemiological studies. As such, the limitations of observational studies, particularly as applied to the health effects of post-menopausal hormone replacement therapy, will be emphasized. We conclude that there is no compelling consistent evidence that post-menopausal hormone replacement therapy either decreases or increases stroke risk. There are, however, reasons to be concerned that this therapy may contribute to stroke risk.

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Hormone replacement therapy: pathobiological aspects of hormone-sensitive cancers in women relevant to epidemiological studies on HRT: a mini-review

Human Reproduction ◽

10.1093/humrep/dei043 ◽

2005 ◽

Vol 20 (8) ◽

pp. 2052-2060 ◽

Cited By ~ 67

Author(s):

M. Dietel ◽

M.A. Lewis ◽

S. Shapiro

Keyword(s):

Hormone Replacement Therapy ◽

Replacement Therapy ◽

Hormone Replacement ◽

Epidemiological Studies ◽

Hormone Sensitive

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Hormone Replacement Therapy and Risk for Neurodegenerative Diseases

International Journal of Alzheimer s Disease ◽

10.1155/2012/258454 ◽

2012 ◽

Vol 2012 ◽

pp. 1-18 ◽

Cited By ~ 17

Author(s):

Richelin V. Dye ◽

Karen J. Miller ◽

Elyse J. Singer ◽

Andrew J. Levine

Keyword(s):

Hormone Replacement Therapy ◽

Neurodegenerative Diseases ◽

Replacement Therapy ◽

Frontotemporal Dementia ◽

Basic Science ◽

Science Studies ◽

Hormone Replacement ◽

Epidemiological Studies ◽

Neurocognitive Disorder ◽

Hiv Associated Neurocognitive Disorder

Over the past two decades, there has been a significant amount of research investigating the risks and benefits of hormone replacement therapy (HRT) with regards to neurodegenerative disease. Here, we review basic science studies, randomized clinical trials, and epidemiological studies, and discuss the putative neuroprotective effects of HRT in the context of Alzheimer’s disease, Parkinson’s disease, frontotemporal dementia, and HIV-associated neurocognitive disorder. Findings to date suggest a reduced risk of Alzheimer’s disease and improved cognitive functioning of postmenopausal women who use 17β-estradiol. With regards to Parkinson’s disease, there is consistent evidence from basic science studies for a neuroprotective effect of 17β-estradiol; however, results of clinical and epidemiological studies are inconclusive at this time, and there is a paucity of research examining the association between HRT and Parkinson’s-related neurocognitive impairment. Even less understood are the effects of HRT on risk for frontotemporal dementia and HIV-associated neurocognitive disorder. Limits to the existing research are discussed, along with proposed future directions for the investigation of HRT and neurodegenerative diseases.

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Increased Risk of Recurrent Venous Thromboembolism during Hormone Replacement Therapy

Thrombosis and Haemostasis ◽

10.1055/s-0037-1614156 ◽

2000 ◽

Vol 84 (12) ◽

pp. 961-967 ◽

Cited By ~ 148

Author(s):

Erik Qvigstad ◽

Harald Arnesen ◽

Stig Larsen ◽

Egil Wickstrøm ◽

Per Sandset ◽

...

Keyword(s):

Placebo Group ◽

Hormone Replacement Therapy ◽

Venous Thromboembolism ◽

Replacement Therapy ◽

Hormone Replacement ◽

Epidemiological Studies ◽

Sequential Design ◽

Controlled Clinical Trial ◽

Double Blind ◽

Increased Risk

SummaryRecent observational studies suggest a 2-4 fold increased risk of venous thromboembolism (VTE) in women taking hormone replacement therapy (HRT). The present study was started before publication of these studies, and the aim was to determine if HRT alters the risk of VTE in high risk women. The study was a randomized, double-blind, and placebo-controlled clinical trial with a doubletriangular sequential design. Females with previously verified VTE were randomized to 2 mg estradiol plus 1 mg norethisterone acetate, 1 tablet daily (n = 71) or placebo (n = 69). The primary outcome was recurrent deep venous thrombosis (DVT) or pulmonary embolism (PE). Between 1996 and 1998 a total of 140 women were included. The study was terminated prematurely based on the results of circumstantial evidence emerging during the trial. Eight women in the HRT group and one woman in the placebo group developed VTE. The incidence of VTE was 10.7% in the HRT group and 2.3% in the placebo group. In the HRT group, all events happened within 261 days after inclusion. The sequential design did not stop the study, but strongly indicated a difference between the two groups. Our data strongly suggests that women who have previously suffered a VTE have an increased risk of recurrence on HRT. This treatment should therefore be avoided in this patient group if possible. The results also support those of recent epidemiological studies, which also indicate increased risk of VTE in non-selected female populations during HRT.

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