Hormone Replacement Therapy in Postmenopausal Women

The possibility of using PAs and SPRMs as a form of nonestrogen hormone replacement therapy for postmenopausal women remains unexplored. Studies in oophorectomized monkeys using the PA ZK 230211 have given encouraging results [100]. 

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Fugere P, Scheele WH, Shah A, et al. (2000) Uterine effects of raloxifene in comparison with continuous-combined hormone replacement therapy in postmenopausal women. Am J Obstet Gynecol 182 568-574... 

Estrogens are most commonly used as a component of combination contraceptives or as hormone replacement therapy in postmenopausal women. Benefits in postmenopausal women include relief of moderate to severe vasomotor symptoms and decreased risk of osteoporosis. Hormone replacement therapy also may be used in vaginal and vulvar atrophy and in hypoestrogenism caused by hypogonadism, castration, or primary ovarian failure. Less commonly, select breast or prostate cancer... 

Lethaby A, Suckling J, Barlow D, Farquhar CM, Jepson RG, Roberts H. Hormone replacement therapy in postmenopausal women endometrial hyperplasia and irregular bleeding. Cochrane Database Syst Rev 2004 (3) CD000402. 

Foster RH, Balfour JA. Estradiol and dydrogesterone. A review of their combined use as hormone replacement therapy in postmenopausal women. Drugs Aging 1997 ll(4) 309-32. 

Prelevic GM, Kocjan T, Markou A. Hormone replacement therapy in postmenopausal women. Minerva Endocrinol. 2005 30 27-36. 

Qarke SC, Kelleher J, Lloyd-Jones H, et al. A study of hormone replacement therapy in postmenopausal women with ischaemic heart disease The Papworth HRT Atherosclerosis Study. Br J Obstet Gynaecol 2002 109 1056-1062. 

Cefalu WT. The use of hormone replacement therapy in postmenopausal women with type 2 diabetes. J Womens Health Gend Based Med 2001 10 241-255. 

Koch B, Oparil S, Stimpel M. Co-administration of an ACE-inhibitor (moexipril) and hormonal replacement therapy in postmenopausal women JHumHypertem (1999) 13, 337-42. 

Corrado F, D Anna R, Caputo F, Cannata ML, Zoccali MG, Cancellieri F. Compliance with hormone replacement therapy in postmenopausal Sicilian women. Eur J Obstet Gynecol Reprod Biol 2005 118 225-8. 

Measurement of steroids in sahva is noninvasive and suitable for the collection of frequent, samples. Serial monitor-ing of estradiol has been used for clinical diagnosis and treatment of infertile women with anovulatory cycles, during in vitro fertilization, or when monitoring hormone replacement therapy of postmenopausal women. Because salivary concentrations of estradiol closely reflect the free fraction of the steroid in plasma, the concentration in sahva is only 1% to 2% of the concentration in blood (1 to 36 pmol/L in nonpregnant women). Hence this requires a sensitive assay for accurate measurement. 

Keating NL, Cleary PD, Rossi AS, et al. Use of hormone replacement therapy by postmenopausal women in the United States. Ann Intern Med 1999 130 545-553. 

For nearly four decades, doctors had routinely prescribed hormone replacement therapy for postmenopausal women to slow down the aging process and to prevent heart disease based on epidemioiogicai studies and iaboratory research, but not ciinicai triais. But then in 2002, the highiy pubiicized Women s Heaith Initiative study (using... 

Wells G, Tugwell P, Shea B, Guyatt G, Peterson J, Zytaruk N, Robinson V, Henry D, O Connell D, Cranney A (2002) Meta-analyses of therapies for postmenopausal osteoporosis. V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women. Endocr Rev 23 529-539... 

Finally, sex steroids are also implicated in the pathophysiology of depression. Estrogen deficiency states, which occur in the postpartum and postmenopausal periods, are thought to play a role in the etiology of depression in some women. Likewise, severe testosterone deficiency in men is sometimes associated with depressive symptoms. Hormone replacement therapy in hypogonadal men and women may be associated with an improvement in mood and depressive symptoms. 

Estradiol (valerate) Estradiol + norethindronate (acetate) Estradiol (valerate ) + levonorgestrel Hormone-replacement therapy in estrogen-deficiency symptoms and prevention of osteoporosis in postmenopausal women... 

Wells G, Tugwell R Shea B, et al. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women. Endocr Rev 2002 23 529-539. 

Lung cancer The precise role of hormone replacement therapy in the development of lung cancer has often been considered unclear. This has been evaluated in a prospective cohort of 36 588 perimenopausal and postmenopausal women aged 50-76 years in Washington State [15. After adjusting for smoking, age, and other potential confounders, there was an increased risk of incident lung cancer associated with... 

KOMULAINEN M, KROGER H, TUPPURAINEN M T, HEIKKINEN A M, ALHAVA E, HONKANEN R, lURVELIN I and SAARiKOSKi s (1999) Prevention of femoral and lumbar bone loss with hormone replacement therapy and vitamin D3 in early postmenopausal women a population-based 5-year randomized trial. J Clin Endocrinol Metab 84, 546-52. 

MORABITO N, CRISAFULLI A, VERGARA C, GAUDIO A, LASCO A, FRISINA N, D ANNA R, CORRADO F, PIZZOLEO M A, CINCOTTA M, ALTAVILLA d, lentile r, squadrito f (2002), Effects of genistein and hormone-replacement therapy on bone loss in early postmenopausal women A randomized double-blind placebo-controlled study. J Bone Miner Res 17, 1904-1912. 

For some conditions, a large placebo effect can be anticipated. For example, studies of hormone replacement therapies for hot flashes in postmenopausal women consistently show a 50% decline from baseline in the number of daily hot flashes in the placebo group. Therefore, in order to show significance, an active treatment must produce an effect that is substantially larger than 50%. A marked placebo response is commonly observed with any condition that has a subjective component, such as chronic pain (e.g. arthritis), episodic pain (e.g. headaches), psychological states (e.g. anxiety), and certain physiologic measurements (e.g. blood pressure). 

Many women seek medical treatment for the relief of menopausal symptoms, primarily hot flashes however, the role of hormone-replacement therapy (HRT) has changed dramatically over the years. HRT has long been prescribed for relief of menopausal symptoms and, until recent years, has been purported to protect women from CHD. The original reason behind recommending HRT in postmenopausal women revolved around a simple theory If the hormones lost during menopause were replaced through drug therapy, women would be protected from both menopausal symptoms and chronic diseases that often follow after a woman experiences menopause. Recent studies have disproved this theory. 

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