scholarly journals OCORRÊNCIA DOS CÂNCERES DE MAMA E ENDOMETRIAL EM MULHERES EM TERAPIA DE REPOSIÇÃO HORMONAL NA MENOPAUSA: UMA REVISÃO DE LITERATURA

2021 ◽  
Vol 7 (7) ◽  
Author(s):  
Gustavo Mariano Rodrigues Santos ◽  
Igor Antônio Galvão Vieira ◽  
Beatriz Costa ◽  
Maria Eduarda Boni Kist ◽  
Fernanda Alves Luz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endometrial Cancer ◽  
Hormone Replacement Therapy ◽  
Breast Neoplasms ◽  
Replacement Therapy ◽  
Estrogen Replacement Therapy ◽  
Hormone Replacement ◽  
Endometrial Neoplasms ◽  
Estrogen Replacement

INTRODUÇÃO: O uso da Terapia de Reposição Hormonal (THR) é prescrito para tratamento de alguns sintomas decorrentes da menopausa. O uso indiscriminado dessa terapêutica parece elevar os riscos de determinadas neoplasias. METODOLOGIA: Trata-se de uma revisão integrativa de literatura, com busca na base de dados Pubmed. Utilizou-se os descritores "Estrogen Replacement Therapy", "Hormone Replacement Therapy", “Menopause”, "Breast Neoplasms", "Breast Cancer", "Endometrial Neoplasms", "Endometrial Cancer", associados aos operadores booleanos AND e OR. Incluíram-se publicações entre 2016 e 2021 nos idiomas português, inglês e espanhol. RESULTADOS: Foram selecionados 20 artigos publicados em periódicos internacionais, sendo 17 estudos de Coorte, dois de Caso-Controle e um Ensaio Clínico Randomizado duplo-cego. DISCUSSÃO: Os estudos analisados sugerem boa resposta no controle dos sintomas pós menopausa pela TRH. Porém, apresenta associação com risco de desenvolvimento de neoplasias de mama e endométrio, ao passo que o uso de estrogênio isolado demonstrou pouca associação. Quando comparados em relação a raça, mulheres brancas apresentam maior risco em relação a negras e asiáticas. CONCLUSÃO: Houve associação do uso de TRH com desenvolvimento das neoplasias estudadas. A duração da terapia, o tipo de hormônio, o momento de início, a via de administração e a população submetida ao tratamento, parecem impactar neste desfecho.

Progestogens are the problem in hormone replacement therapy: Time to reappraise their use

2019 ◽  
Vol 26 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Isaac Manyonda ◽  
Vikram S Talaulikar ◽  
Roxanna Pirhadi ◽  
Joseph Onwude
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Estrogen Replacement Therapy ◽  
Hormone Replacement ◽  
Underlying Mechanism ◽  
Limiting Factor ◽  
Estrogen Replacement ◽  
Increased Risk ◽  
Reduce Breast Cancer Risk

Combined (estrogen and a progestogen) hormone replacement therapy (cHRT) is associated with an increased risk of breast cancer, while estrogen replacement therapy is not. Whatever the underlying mechanism, it is the progestogen in cHRT that seems to increase the risk. Fear of breast cancer is a major limiting factor in the use of hormone replacement therapy, and when women discontinue cHRT because of side effects, the latter are often attributable to the progestogen component. cHRT is given to women with an intact uterus to protect against the effects of un-opposed estrogen such as an increased risk of endometrial cancer. Estrogen replacement therapy suffices for women with a prior hysterectomy. There is a clear distinction in risk and side effect profile between cHRT and estrogen replacement therapy. Apart from being the most effective treatment for menopausal symptoms, estrogen prevents osteoporosis, and may also have a potential role in prevention of Alzheimer’s Dementia, now the biggest killer of women in the United Kingdom. Evidence also suggests that progestogens could compromise the dementia-preventative effect of estrogen. Given the immense therapeutic and preventative potential of estrogen, the use of progestogens in cHRT needs re-appraisal. The levonorgestrel intrauterine system (LNg-IUS) could reduce breast cancer risk while protecting the endometrium. Other approaches to the safe use of progestogens await research.

The effects of estrogen and hormone replacement therapy on cardiovascular systems

2020 ◽  
Author(s):  
Mehrnoosh Hashemzadeh ◽  
Ryan Romo ◽  
Joseph M Arreguin ◽  
Mohammed Reza Movahed
Keyword(s):  
Hormone Replacement Therapy ◽  
Cardiovascular System ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Estrogen Replacement Therapy ◽  
Hormone Replacement ◽  
Future Research ◽  
Estrogen Replacement ◽  
Increased Risk ◽  
Cardiovascular Benefit

Postmenopausal women have an increased risk of cardiovascular disease, which is believed to correlate with lower estrogen level. There are conflicting data regarding hormone replacement therapy (HRT) based on the timing of this therapy. After large randomized trials showed no cardiovascular benefit of hormone replacement, estrogen replacement therapy was dramatically reduced even though starting hormone replacement in early postmenopausal period had shown significant benefit. There are hardly any reviews discussing in detail the effect of HRT on cardiovascular system while briefly discussing other effects of this therapy in postmenopausal women. The novelty of this review is the comprehensive discussion of this effect that can help researchers and clinicians to design future research or trials. In this manuscript, the effect of HRT on cardiovascular system in clinical trials and basic science will be reported and potentially erroneous conclusions drawn by various studies will be discussed. Furthermore, various noncardiovascular effect of HRT will be analyzed.

Lipoprotein Disorders in Women: Which Women are the Best Candidates for Hormone Replacement Therapy?

1997 ◽  
Vol 31 (1) ◽  
pp. 98-107 ◽  
Author(s):  
Susyn L Plushner
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Estrogen Replacement Therapy ◽  
Hormone Replacement ◽  
High Density ◽  
High Density Lipoproteins ◽  
Estrogen Replacement ◽  
Recent Trial ◽  
Lipoprotein Disorders

OBJECTIVE: To review the data examining hormone replacement therapy (HRT) in the treatment of lipoprotein disorders in women. DATA SOURCE: A MEDLINE search (1975–1995) of the English-language literature was performed to identify pertinent primary literature and review articles. Articles were also identified through bibliographies of selected articles. DATA EXTRACTION: Controlled and uncontrolled studies evaluating the effects of lipoprotein concentrations on coronary risk and the effects of estrogen and HRT on coronary heart disease and lipoprotein concentrations in women were evaluated. Trials pertaining to adverse effects of therapy were also examined. Emphasis was placed on recent clinical trials. DATA SYNTHESIS: The National Cholesterol Education Program's (NCEP's) 1993 report recommends estrogen replacement therapy as a treatment option in postmenopausal women with hyperlipidemia. Recent trials suggesting that triglycerides and high-density lipoproteins are more closely related to coronary risks in women necessitate an improved understanding of estrogen and progestin's effects on lipoprotein concentrations. A recent trial has clarified the lipoprotein effects of HRT in women with normal lipid concentrations and suggests that beneficial effects on low-density lipoproteins are maintained, although progestins attenuate beneficial changes in high-density lipoproteins and triglyceride elevations persist. The few trials evaluating estrogen use in women with hyperlipidemia suggest a beneficial effect as well. CONCLUSIONS: In the absence of contraindications, postmenopausal women with hyperlipidemia should be offered estrogen replacement therapy as conjugated equine estrogen 0.625 mg/d. Pending further information, NCEP's recommendations should be followed regarding goals of therapy.

The Effects of Transdermal Estradiol and Oral Conjugated Estrogens on Haemostasis Variables

1994 ◽  
Vol 71 (04) ◽  
pp. 420-423 ◽  
Author(s):  
Ulla-Beth Kroon ◽  
G Silfverstolpe ◽  
L Tengborn
Keyword(s):  
Replacement Therapy ◽  
Estrogen Replacement Therapy ◽  
Hormone Replacement ◽  
Plasminogen Activator Inhibitor ◽  
Estrogen Replacement ◽  
Transdermal Administration ◽  
Conjugated Estrogens ◽  
Transdermal Estradiol ◽  
Estrogen Administration ◽  
Activator Inhibitor

SummaryThe effects of oral and transdermal administration of estrogen replacement therapy (ERT) have been fairly well investigated regarding lipoprotein and carbohydrate metabolism, while the effects of different modes of estrogen administration on the haemostatic system have been less well studied.To delineate and compare the effects of perorally administered conjugated estrogens (CE) and transdermally administered estradiol (E2) in doses needed for hormone replacement therapy (HRT) on haemostasis parameters, 23 postmenopausal women were engaged in a study with an open cross-over design. The doses compared (0.625 mg CE and 50 μg E2/24h) are the lowest which, with few exceptions, eliminate climacteric symptoms. Both CE and E2 increased factor VII:C, factor VII:Ag, and the prothrombin fragment1+2. The increase in factor VII:Ag, however, was significantly higher after treatment with CE. These changes were all towards a state of hypercoagulability. Furthermore, CE decreased plasminogen activator inhibitor (PAI) and the thrombin-antithrombin complexes (TAT), as well as antithrombin (ATIII).

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