Benefits and risks of postmenopausal hormone therapy when it is initiated soon after menopause
Authors
Prentice, Ross L.Manson, JoAnn E.
Langer, Robert D.
Anderson, Garnet L.
Pettinger, Mary B.
Jackson, Rebecca D.
Johnson, Karen C.
Kuller, Lewis H.
Lane, Dorothy S.
Wactawski-Wende, Jean
Brzyski, Robert
Allison, Matthew A.
Ockene, Judith K.
Sarto, Gloria E.
Rossouw, Jacques E.
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDocument Type
Journal ArticlePublication Date
2009-07-01Keywords
AgedBreast Neoplasms
Colorectal Neoplasms
Contraceptive Agents, Female
Coronary Disease
Endometrial Neoplasms
Estrogen Replacement Therapy
Estrogens
Estrogens, Conjugated (USP)
effects
Female
Follow-Up Studies
Fractures, Bone
Humans
Incidence
Medroxyprogesterone Acetate
Menopause
Middle Aged
Postmenopause
Progestins
Pulmonary Embolism
Retrospective Studies
Risk Factors
Stroke
Survival Rate
Thrombosis
Time Factors
Washington
Life Sciences
Medicine and Health Sciences
Women's Studies
Metadata
Show full item recordAbstract
The authors further analyzed results from the Women's Health Initiative randomized trials (1993-2004) of conjugated equine estrogens, with or without medroxyprogesterone acetate, focusing on health benefits versus risks among women who initiated hormone therapy soon after menopause. Data from the Women's Health Initiative observational study (1993-2004) were included in some analyses for additional precision. Results are presented here for incident coronary heart disease, stroke, venous thromboembolism, breast cancer, colorectal cancer, endometrial cancer, or hip fracture; death from other causes; a summary global index; total cancer; and total mortality. Hazard ratios for breast cancer and total cancer were comparatively higher (P < 0.05) among women who initiated hormone therapy soon after menopause, for both regimens. Among these women, use of conjugated equine estrogens appeared to produce elevations in venous thromboembolism and stroke and a reduction in hip fracture. Estrogen plus progestin results among women who initiated use soon after menopause were similar for venous thromboembolism, stroke, and hip fracture but also included evidence of longer-term elevations in breast cancer, total cancer, and the global index. These analyses provide little support for the hypothesis of favorable effects among women who initiate postmenopausal estrogen use soon after menopause, either for coronary heart disease or for health benefits versus risk indices considered.Source
Am J Epidemiol. 2009 Jul 1;170(1):12-23. Epub 2009 May 25. Link to article on publisher's site
DOI
10.1093/aje/kwp115Permanent Link to this Item
http://hdl.handle.net/20.500.14038/50967PubMed ID
19468079Related Resources
ae974a485f413a2113503eed53cd6c53
10.1093/aje/kwp115