scholarly journals Hormone replacement therapy and the risk of subarachnoid hemorrhage in postmenopausal women

2016 ◽  
Vol 124 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Ahmed A. Malik ◽  
Omar Saeed ◽  
Archie Defillo ◽  
Gregory T. Sherr ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Subarachnoid Hemorrhage ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Proportional Hazards ◽  
Hormone Replacement ◽  
Cox Proportional Hazards ◽  
Absolute Difference ◽  
Unruptured Aneurysms

OBJECT The incidence of subarachnoid hemorrhage (SAH) increases after menopause. Anecdotal data suggest that hormone replacement therapy (HRT) may reduce the rate of SAH and aneurysm formation in women. The goal of this study was to determine the effect of HRT on occurrence of SAH in a large prospective cohort of postmenopausal women. METHODS The data were analyzed for 93, 676 women 50–79 years of age who were enrolled in the observational arm of the Women’s Health Initiative Study. The effect of HRT on risk of SAH was determined over a period of 12 ± 1 years (mean ± SD) using Cox proportional hazards analysis after adjusting for potential confounders. Additional analysis was performed to identify the risk associated with “estrogen only” and “estrogen and progesterone” HRT among women. RESULTS Of the 93, 676 participants, 114 (0.1%) developed SAH during the follow-up period. The rate of SAH was higher among women on active HRT compared with those without HRT used (0.14% vs 0.11%, absolute difference 0.03%, p < 0.0001). In unadjusted analysis, participants who reported active use of HRT were 60% more likely to suffer an SAH (RR 1.6, 95% CI 1.1–2.3). Compared with women without HRT use, the risk of SAH continued to be higher among women reporting active use of HRT (RR 1.5, 95% CI 1.0–2.2) after adjusting for age, systolic blood pressure, cigarette smoking, alcohol consumption, body mass index, race/ethnicity, diabetes, and cardiovascular disease. The risk of SAH was nonsignificantly higher among women on “estrogen only” HRT (RR 1.4, 95% CI 0.91–2.0) than “estrogen and progesterone” HRT(RR 1.2, 95% CI 0.8–2.1) after adjusting for the above-mentioned confounders. CONCLUSIONS Postmenopausal women, particularly those at risk for SAH due to presence of unruptured aneurysms, family history, or cardiovascular risk factors, should be counseled against use of HRT.

scholarly journals Association Between Hormone Replacement Therapy and Development of Endometrial Cancer: Results From a Prospective US Cohort Study

2022 ◽  
Vol 8 ◽  
Author(s):  
Ying Liang ◽  
Haoyan Jiao ◽  
Lingbo Qu ◽  
Hao Liu
Keyword(s):  
Endometrial Cancer ◽  
Cohort Study ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Large Scale ◽  
Proportional Hazards ◽  
Hormone Replacement ◽  
Cox Proportional Hazards

Although hormone replacement therapy (HRT) use is associated with elevated endometrial cancer(EC) risk, little evidence assesses potential effect-modifiers on HRT-related EC in a long-term follow-up. In this large-scale longitudinal cohort study, we tried to evaluate the association between different HRT types/methods use and risk of EC, and reveal this risk within different body mass index (BMI) groups. In whole cohort, 677 EC occurred during mean 11.6 years follow-up. Cox proportional hazards regression was used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs) with HRT status (never, former, or current) for risk of EC incidence. Current HRT use was not significantly associated with EC risk (HR for current vs. never HRT use: 1.13; 95% CI: 0.92, 1.38) in the whole cohort, but presented a dose-response effect on increased EC risk (HR for &gt;10-year use vs. never HRT use: 1.73; 95% CI: 1.35, 2.21). Moreover, EC risk differed in distinct regimens or subsets (all Pinteraction &lt; 0.05). Estrogen-only use was associated with elevated EC risk (HR for current vs. never HRT use: 1.51; 95% CI: 1.12, 2.04), but women with high BMI (&gt; 30 kg/m2) who currently use estrogen-only harbored decreased EC risk (HR: 0.56; 95% CI: 0.38, 0.82) compared to counterparts without HRT use. Estrogen-only use is associated with increased EC risk, and precise monitoring of EC development for postmenopausal women with long-term HRT use are urgently needed. BMI could serve as an important surrogate to assess this risk.

Past use of hormone replacement therapy and risk of invasive breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10518-10518 ◽  
Author(s):  
W. Y. Chen ◽  
S. E. Hankinson ◽  
B. Rosner ◽  
G. A. Colditz
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement Therapy ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Invasive Breast Cancer ◽  
Hormone Replacement ◽  
The Relationship

10518 Background: Although current use of hormone replacement therapy (HRT) is associated with a greater risk of breast cancer than past use, the effects of longer term past use of HRT are not well quantified. Methods: We examined the relationship between past HRT use and invasive breast cancer risk within the Nurses’ Health Study, a prospective cohort of 121,700 registered nurses aged 30–55 in 1976 who update information on cancer risk factors and outcomes through biennial questionnaires. For this analysis, the follow-up period was 1980 through 2004 and only included person-time for postmenopausal women. Status of HRT use (never, past, or current), type of HRT (oral unopposed estrogen (E alone) or combination oral estrogen + progesterone (E+P)), and duration of HRT use were assessed every 2 years and defined prospectively. Proportional hazards models controlled for age, body mass index, parity, age at first birth, family history of breast cancer, benign breast disease, alcohol consumption, type of menopause, and ages at menarche and menopause. Results: During 1,388,368 person-years of follow-up among postmenopausal women, invasive breast cancer was diagnosed among 1,554 women who had never used HRT, 459 past users of E+P and 527 past users of E alone. Regardless of duration of use, past use of E alone was not associated with breast cancer risk. Although past use of E+P for less than 10 years was not associated with breast cancer risk (RR (95% CI) 1.01 (0.88–1.17) for < 5 years and 0.95 (0.74–1.21) for 5–9.9 years), past use of E+P for greater than 10 years was associated with an increased risk of breast cancer (RR 1.53 (1.09–2.16) for 10–14.9 years and 1.48 (0.87–2.51) for 15 or more years). Results were similar regardless of time since last use, although power was limited for this subgroup analysis. Conclusions: Past use of E+P for greater than 10 years was associated with a persistent elevation in breast cancer risk. The relationship between duration of past use and breast cancer risk did not appear linear, but suggested a possible threshold effect. No significant financial relationships to disclose.

Safety of hormone replacement therapy in women with a history of cervical adenocarcinoma

2021 ◽  
pp. 205336912110285
Author(s):  
A Richardson ◽  
L Watson ◽  
M Persic ◽  
A Phillips
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Proportional Hazards ◽  
Hormone Replacement ◽  
Cox Proportional Hazards ◽  
Intention To Treat ◽  
Kaplan Meier ◽  
Estrogen Receptor Positivity ◽  
History Of ◽  
Cervical Adenocarcinomas

Objectives Studies investigating the safety of hormone replacement therapy in cervical cancer have predominantly included patients with squamous disease. Pathological studies have identified estrogen receptor positivity in cervical adenocarcinomas. A recent small case-control study suggested a trend towards reduced survival with hormone replacement therapy in cervical adenocarcinomas. Our objective was to determine if hormone replacement therapy use in patients treated for cervical adenocarcinomas is detrimental to survival. Study design A retrospective review of all women under the age of 50 with stage 1B-2B cervical adenocarcinomas diagnosed between 1 November 2000 and 24 September 2019. Women were categorised into three groups: ovaries conserved (OVCON); or iatrogenic menopause with (IM-HRT) or without (IM-NOHRT) hormone replacement therapy. Hormone replacement therapy use was defined on an intention to treat basis. Statistical analysis was performed using Kaplan-Meier and Cox proportional hazards methods. Main outcome measures Overall (OS), disease specific (DSS) and progression free (PFS) survival. Results A total of 58 women (mean age 38.5 ± 6.6) were included in the study of whom 25 (43.1%) had OVCON, 20 (34.4%) had IM-HRT and 13 (22.4%) had IM-NOHRT. No menopause-associated deaths occurred. Although five-year DSS was 73% in IM-NOHRT compared to 95% in IM-HRT and 95% in OVCON, these differences were not statistically significant. Five-year PFS was 68% in IM-NOHRT compared to 90% in IM-HRT and 81% in OVCON but again, these differences were not statistically significant. Conclusion In this small study, hormone replacement therapy does not appear to be detrimental to survival in cervical adenocarcinomas. There is a trend towards improved survival with hormone replacement therapy. Larger studies are required to substantiate these findings.

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