Menopause, estrogen replacement

Oral post-menopausal estrogen replacement therapy increases circulating concentrations of C-reactive protein, but in 68 women who took a combination of transdermal 17-beta-estradiol and micronized progesterone there was no significant effect of transdermal estrogen on C-reactive protein concentrations compared with placebo (86). 

Dupont WD, Page DL. Menopausal estrogen replacement therapy and breast cancer. Arch Intern Med 1991 151 67-72. 

Women >55 years or premature menopause without estrogen-replacement therapy Family history of premature CHD (definite myocardial infarction or sudden death before 55 years of age in father or other male first-degree relative or before 65 years of age in mother or other female first-degree relative) Cigarette smoking... 

Pacifici R, Brown C, Puscheck E, Friedrich E, Slatopolsky E, Maggio D, McCracken R, Avioli LV (1991) Effect of surgical menopause and estrogen replacement on cytokine release from human blood mononuclear cells. Proc Nad Acad Sci USA 88 5134-5138... 

Positive risk factors for CHD (other than high LDL) include Age (men 45 years of age or older women 55 years of age or older or women who go through premature menopause without estrogen replacement therapy) family history of premature CHD smoking hypertension (greater than 140/90 mm Hg) low HDL cholesterol (less than 35 mg/dL) obesity (more than 30% overweight) and diabetes mellitus. 

Schairer C et al. Menopausal estrogen and estrogen-progestin replacement therapy and breast cancer risk. JAMA 2000 283 485-491. 

Journal of the Royal College of General Practitioners 31 134-40, 1981 Coope J, Thomson J, Poller L Effects of natural estrogen replacement therapy on menopausal symptoms and blood clotting. BMJ 4 139-143, 1975 Cooper GL The safety of fluoxetine—an update. Br J Psychiatry 153 [suppl 3) 77-86, 1988... 

Ohkura T, Isse K, Akazawa K, et al Low-dose estrogen replacement therapy for Alzheimer disease in women. Menopause The Journal of the North American Menopause Society 1 [3) 125-130, 1994... 

Beller FK, Nachtigall L, Rosenberg M. Coagulation studies of menopausal women taking estrogen replacement. Obstet Gynecol 1972 39(5) 775-8. 

Female >55 years old, or premature menopause without estrogen replacement therapy +1 Family history or premature CHD ... 

Although estrogen replacement therapy at menopause can prevent bone loss and cardiovascular disease, there is evidence that estrogens are associated with an increased risk of breast cancer as well as endometrial cancer(Gambrell, 1994), which thus seriously limits the use of estrogen replacement therapy. The ideal compound for women s health should be one able to decrease the risk of the most important causes of morbidity and mortality in women, namely breast cancer, uterine cancer, osteoporosis, bone fractures, and cardiovascular disease. Heart disease is, in fact, the leading cause of death in postmenopausal women (Lerner and Kannel, 1986). This ideal compound should also have an excellent safety profile to ensure compliance over 20 to 40 years of a woman s life. 

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