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Estrogen and progestegen use in postmenopausal women: 2010 position statement of The North American Menopause Society

Menopause (Impact Factor: 2.81). 01/2010; Vol 17(2):242-255. DOI: 10.1097/gme.0b013e3181d0f6b9
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    ABSTRACT: Hormone therapy (HT) is used for controlling menopausal symptoms. It has also been used for the management and prevention of chronic diseases such as cardiovascular disease, osteoporosis and dementia in older women. The present review assessed the clinical effects of using HT for a year or more. Twenty-three randomised double-blind studies (involving 42,830 women aged 26 to 91 years) compared HT (all oestrogens, with or without progestogens, administered by oral, transdermal, subcutaneous or intranasal routes) with placebo when taken for at least one year. Most participants were postmenopausal American women, and the mean age in most studies was over 60 years. No study focused on perimenopausal women. In relatively healthy postmenopausal women (14 studies), combined continuous HT significantly increased the risk of obstruction of a vein by a blood clot (venous thrombo-embolism), fatal or nonfatal heart attack (after one year's use), stroke (after three years' use), breast cancer, gallbladder disease, death from lung cancer, and dementia in women over 65 years. Long term oestrogen alone significantly increased the risk of venous thrombo-embolism, stroke and gallbladder disease. Among postmenopausal women with cardiovascular disease (six studies) long term use of combined HT significantly increased the risk of venous thrombo-embolism, particularly in the first two years of use, and of gallbladder disease. HT offered the benefit of a significant reduction in the risk of bone fracture but only after four or five years' treatment with HT, while the highest risk of cardiovascular events with combined HT occurred in the first year of use. There was no convincing evidence that HT prevents colorectal cancer.
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    ABSTRACT: Cardiovascular disease (CVD) is the leading cause of death in women, and disparities affect the diagnosis, treatment, and outcomes of CVD for women. Biology, genetics, and race contribute to these disparities. Obstetric-gynecologic health care providers routinely encounter women who are at risk for developing CVD and are uniquely positioned as a point of access to intervene to improve/prevent CVD by assessing for risks and discussing healthy lifestyle changes during routine visits.
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    ABSTRACT: OVERVIEW: This article describes the findings and limitations of the major research thus far on hormone therapy, particularly that of the Women's Health Initiative; examines practice recommendations; clarifies common terminology related to menopause and hormone therapy; and provides the implications for nurses. This is part one of a four-part series on postmenopausal health. KEYWORDS: bioidentical hormones, combined estrogen and progestogen therapy, estrogen, estrogen therapy, hormone therapy, menopause, menopausal transition, postmenopause, progestin, progestogen, women's health, Women's Health Initiative.
    The American journal of nursing 06/2011; 111(6):38-47; quiz 48-9. DOI:10.1097/01.NAJ.0000398539.52283.55 · 1.32 Impact Factor
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