LaCroix and colleagues [1] recently reported health outcomes after stopping therapy among postmenopausal women randomized to conjugated equine estrogens (CEE) in the estrogen-only arm of the Women’s Health Initiative. A total of 7645 women (78% of the original cohort) gave consent to be included in this follow-up over a mean duration of 10.7 years. Post-intervention use of estrogen replacement therapy (ERT) in the two groups was 3% and 2.7%, respectively. Post-intervention annualized rates comparing women originally randomized to CEE with those randomized to placebo were reported for the following conditions: coronary heart disease: hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.75–1.25; breast cancer: HR 0.75, 95% CI 0.51–1.09; stroke: HR 0.89, 95% CI 0.64–1.24; venous thrombosis: HR 0.63, 95% CI 0.41–0.98; hip fracture: HR 1.27, 95% CI 0.88–1.82. Over the entire follow-up period (i.e. the active treatment intervention phase [i]and[/i] the post-intervention follow-up), the incidence of breast cancer was lower in the CEE group (HR 0.77, 95% CI 0.62–0.95).
Author(s)
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Rodney J. Baber
Associate Professor of Obstetrics and Gynaecology at The University of Sydney, Head, Menopause Unit, The Royal North Shore Hospital of Sydney, New South Wales, Australia
Citations
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LaCroix AZ, Chlebowski RT, Manson JE, et al. Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hysterectomy. JAMA 2011;305:1305-14.
http://www.ncbi.nlm.nih.gov/pubmed/21467283 -
Anderson GL, Limacher M, Assaf AR, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy. The Womens Health Initiative randomized control trial. JAMA 2004;291:1701-12.
http://www.ncbi.nlm.nih.gov/pubmed/15082697 -
Clarkson TB. Estrogen effects on arteries vary with stage of reproductive life and extent of subclinical atherosclerosis progression. Menopause 2007;14:373-84.
http://www.ncbi.nlm.nih.gov/pubmed/17438515 -
Rossouw J, Prentice RL, Manson JE, et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since the menopause. JAMA 2007;297:1465-77.
http://www.ncbi.nlm.nih.gov/pubmed/17405972 -
Sturdee DW, Pines A; International Menopause Society Writing Group. Updated IMS recommendations on postmenopausal hormone therapy and preventive strategies for midlife health. Climacteric 2011;14: in press
-
Salpeter SR, Cheng J, Thabane L, et al. Bayesian meta-analysis of hormone therapy and mortality in younger postmenopausal women. Am J Med 2009; 122:1016-22.
http://www.ncbi.nlm.nih.gov/pubmed/19854329 -
Hodis HN, Mack WJ. Coronary heart disease and hormone replacement therapy after the menopause. Climacteric 2009;12(Suppl 1):71-5.
http://www.ncbi.nlm.nih.gov/pubmed/19811246 -
Postmenopausal hormone therapy: An Endocrine Society Scientific Statement. J Clin Endocrinol Metab 2010;95(Suppl 1):No 07.
http://www.endo-society.org/journals/scientificstatements/ -
Hulley SB, Grady D. The WHI estrogen-alone trial do things look any better? JAMA 2004;291:1769-71.
http://www.ncbi.nlm.nih.gov/pubmed/15082705 -
Jungheim ES, Colditz GA. Short term use of unopposed estrogens: a balance of inferred risks and benefits. JAMA 2011;305:1354-5.
http://www.ncbi.nlm.nih.gov/pubmed/21467291
