1. Benefits and risks of postmenopausal hormone therapy when it is initiated soon after menopause.
- Author
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Prentice RL, Manson JE, Langer RD, Anderson GL, Pettinger M, Jackson RD, Johnson KC, Kuller LH, Lane DS, Wactawski-Wende J, Brzyski R, Allison M, Ockene J, Sarto G, and Rossouw JE
- Subjects
- Aged, Breast Neoplasms prevention & control, Colorectal Neoplasms epidemiology, Contraceptive Agents, Female adverse effects, Contraceptive Agents, Female therapeutic use, Coronary Disease prevention & control, Endometrial Neoplasms epidemiology, Estrogens adverse effects, Estrogens therapeutic use, Estrogens, Conjugated (USP) administration & dosage, Estrogens, Conjugated (USP) adverse effects, Female, Follow-Up Studies, Fractures, Bone epidemiology, Fractures, Bone prevention & control, Humans, Incidence, Medroxyprogesterone Acetate adverse effects, Menopause, Middle Aged, Progestins adverse effects, Pulmonary Embolism epidemiology, Retrospective Studies, Risk Factors, Stroke epidemiology, Survival Rate trends, Thrombosis epidemiology, Time Factors, Washington epidemiology, Breast Neoplasms epidemiology, Coronary Disease epidemiology, Estrogen Replacement Therapy adverse effects, Estrogens, Conjugated (USP) therapeutic use, Medroxyprogesterone Acetate therapeutic use, Postmenopause drug effects, Progestins therapeutic use
- Abstract
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.
- Published
- 2009
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