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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Controversies in HRT.

BACKGROUND: Short term hormone replacement therapy (HRT) use is well established for menopausal symptom relief.

However, the rates and duration of HRT use are increasing in Australia while the benefits and risks of long term HRT remain controversial.

OBJECTIVE: To review the evidence for the use of HRT for the prevention of cardiovascular disease (CVD) and osteoporosis as well as the increased risks of thrombosis and, potentially, breast cancer.

Extensive epidemiological data suggests that HRT may protect against CVD and fracture, potentially offering significant long term health benefits to postmenopausal women.

However, limited controlled trials focusing on CVD prevention have suggested no benefit from HRT.

Also, there is limited controlled fracture end point data to support HRT use for the treatment of osteoporosis.

Furthermore, potential benefits of long term HRT use need to be balanced against the risks of use, including increased thrombosis and potentially as suggested from epidemiological studies, increased breast cancer.

[MeSH-major] Estrogen Replacement Therapy. Risk Assessment. Treatment Outcome

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(PMID = 12043543.001).

[ISSN] 0300-8495

[Journal-full-title] Australian family physician

[ISO-abbreviation] Aust Fam Physician

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] Australia

[Chemical-registry-number] 0 / Estrogens

[Number-of-references] 34

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] HRT: the woman's perspective.

Questionnaire studies in Europe show that women's concerns at the menopause are more related to their self-image and sexual identity than to medical consequences such as osteoporosis or coronary heart disease.

Women long for help with menopausal problems, yet are concerned about the potential side effects of HRT and often perceive the information they receive from their doctors to be inadequate.

Adverse effects of menopausal estrogen deprivation on sexual and psychological function occur via two main mechanisms.

Estrogen replacement in hormone replacement therapy (HRT) improves both sexual and psychological self-image and function.

[MeSH-major] Estrogen Replacement Therapy / psychology. Menopause / psychology. Patient Satisfaction

MedlinePlus Health Information. consumer health - Menopause.

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(PMID = 8666121.001).

[ISSN] 0020-7292

[Journal-full-title] International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

[ISO-abbreviation] Int J Gynaecol Obstet

[Language] eng

[Publication-type] Journal Article

[Publication-country] IRELAND

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [HRT in 2006].

[Transliterated title] HRT roku 2006.

According to present terminology, the name: hormonal replacement therapy (as the use of ovarian hormones in postmenopausal women) is replaced by the systemic estrogen therapy (ET) and combined combined estrogen-progestogen therapy (EPT).

Treatment with estrogen and progestagens in this period of women's life is accepted intervention only when the strict defined conditions of this therapy are maintained.

This paper introduces present rules of the use of systemic ET and EPT according to statements of experts who are interested of menopausal women' treatment.

[MeSH-major] Estrogens / therapeutic use. Hormone Replacement Therapy. Progestins / therapeutic use. Women's Health

[MeSH-minor] Estrogen Replacement Therapy. Female. Humans. Menopause. Terminology as Topic. World Health Organization

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(PMID = 16821217.001).

[ISSN] 0423-104X

[Journal-full-title] Endokrynologia Polska

[ISO-abbreviation] Endokrynol Pol

[Language] pol

[Publication-type] English Abstract; Journal Article; Review

[Publication-country] Poland

[Chemical-registry-number] 0 / Estrogens; 0 / Progestins

[Number-of-references] 15

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] HRT and dementia.

The role of HRT and/or oestrogens in the aetiology, progression and prevention of neurodegenerative disorders is unclear.

The following is a presentation of data on the role of oestrogens in the two most common dementia syndromes Alzheimer's Disease and vascular dementia.

Observational studies give some support to the hypothesis that HRT may be protective for cognitive decline and dementia in the elderly, but the inherited methodological problems in these studies preclude any conclusions.

The treatment trials published thus far have methodological problems that prohibit definite conclusions on the relationship between HRT and cognitive decline and dementia.

[MeSH-major] Alzheimer Disease / prevention & control. Dementia, Vascular / prevention & control. Estrogen Replacement Therapy / methods

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(PMID = 10695961.001).

[ISSN] 1359-5229

[Journal-full-title] Journal of epidemiology and biostatistics

[ISO-abbreviation] J Epidemiol Biostat

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] ENGLAND

[Chemical-registry-number] 0 / Estrogens

[Number-of-references] 198

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Drospirenone in HRT?

Drospirenone is a synthetic progestogen contained, with estradiol, in the hormone replacement therapy (HRT) product black triangle downAngeliq (Bayer Schering Pharma).

[MeSH-minor] Aged. Blood Pressure / drug effects. Body Weight / drug effects. Bone Density / drug effects. Drug Costs. Female. Hormone Replacement Therapy / economics. Hormone Replacement Therapy / methods. Humans. Middle Aged. Postmenopause / drug effects. Practice Guidelines as Topic

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(PMID = 19357298.001).

[ISSN] 0012-6543

[Journal-full-title] Drug and therapeutics bulletin

[ISO-abbreviation] Drug Ther Bull

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] England

[Chemical-registry-number] 0 / Androstenes; 0 / Progesterone Congeners; N295J34A25 / drospirenone

[Number-of-references] 19

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The menopause and HRT. HRT and cognitive decline.

It is biologically plausible that hormone replacement therapy (HRT) would be protective against cognitive decline and Alzheimer's disease (AD).

We review observational and randomized trials to determine whether HRT might protect against cognitive decline in cognitively unimpaired and demented women.

We also address issues of clinical relevance, including duration and type of treatment and patient characteristics, including type of menopause (surgical versus natural), age, education and menopausal symptoms.

Differences in participant characteristics and testing methods limit the ability to draw conclusions across randomized studies of HRT in non-demented women.

The available evidence suggests no detrimental effect of HRT on cognitive function and inconsistent benefits on verbal memory and reasoning, frontal functions and speeded attention.

Meta-analyses of observational trials suggest that HRT protects against the development of AD, but randomized trials indicate no long-lasting benefit in patients with AD.

Evidence is insufficient to recommend HRT to maintain cognitive function.

[MeSH-major] Dementia / prevention & control. Estrogen Replacement Therapy. Estrogens / therapeutic use

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(PMID = 12763515.001).

[ISSN] 1521-690X

[Journal-full-title] Best practice & research. Clinical endocrinology & metabolism

[ISO-abbreviation] Best Pract. Res. Clin. Endocrinol. Metab.

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review

[Publication-country] England

[Chemical-registry-number] 0 / Estrogens; 0 / Progestins

[Number-of-references] 96

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] HRT in difficult circumstances: are there any absolute contraindications?

Many traditional contraindications to hormone replacement therapy (HRT) are based on the theoretical potential for these hormones to worsen a disease process and are rarely based on supporting data.

This review addresses the available data and lack of data that make the prescription of HRT difficult in a variety of common morbidities.

In each circumstance, it is assumed that conservative evidence-based therapies have been tried and that menopausal symptoms remain debilitating and are reducing quality of life.

Tailoring of the product, dose, route and regimen may avoid some of the theoretical risks of HRT in particular women or conditions and guidelines are given for each co-morbidity.

Specifically, it is discussed that tailored HRT may be used without strong evidence of a deleterious effect after ovarian cancer, endometrial cancer, most other gynecological cancers, bowel cancer, melanoma, a family history of breast cancer, benign breast disease, in carriers of BRACA mutations, after breast cancer if adjuvant therapy is not being used, past thromboembolism, varicose veins, fibroids and past endometriosis.

Relative contraindications are existing cardiovascular and cerebrovascular disease and breast cancer being treated with adjuvant therapies.

Consultation with other carers and written consent are recommended in all these difficult circumstances, but no condition is an absolute contraindication to HRT if potential risk is understood, if HRT is effective in symptom control and if quality of remaining life is paramount.

[MeSH-major] Estrogen Replacement Therapy / contraindications

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(PMID = 21355685.001).

[ISSN] 1473-0804

[Journal-full-title] Climacteric : the journal of the International Menopause Society

[ISO-abbreviation] Climacteric

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] England

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] HRT: have we changed?

BACKGROUND: In recent years, medical controversy, has surrounded the prescribing of hormone replacement therapy (HRT).

AIM: This study aimed to establish whether prescribing of HRT in Northern Ireland has changed and what the current prescribing patterns are.

RESULTS: Overall 54% of respondents indicated that they had changed their prescribing practice on HRT in the past year.

The primary indication for prescribing HRT was vasomotor symptoms (93%).

CONCLUSIONS: More than half of all doctors who responded had changed their prescribing practices on HRT, yet some respondents still preferred more traditional prescribing.

[MeSH-major] Attitude of Health Personnel. Estrogen Replacement Therapy / trends. Physician's Practice Patterns

[MeSH-minor] Complementary Therapies. Female. Humans. Northern Ireland. Questionnaires

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(PMID = 17312831.001).

[ISSN] 0021-1265

[Journal-full-title] Irish journal of medical science

[ISO-abbreviation] Ir J Med Sci

[Language] eng

[Publication-type] Journal Article

[Publication-country] Ireland

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Appropriate use of HRT post-menopause.

The last decade has seen a dramatic increase in the use of, and interest in, hormone replacement therapy (HRT) in the United Kingdom, with its undoubted benefits in relieving distressing symptoms associated with the menopause, protecting the skeleton and preventing ischaemic heart disease.

Recent studies, however, suggest that compliance with therapy tends to be poor.

In this article, the author examines some of the reasons why the drop-out rate is so high in women who start hormone replacement therapy, and suggests there are three broad areas in which there is need for improvement: more counselling of patients, dispelling unrealistic expectations which some women may have of HRT and, most importantly, the need for the individualization of therapy to suit the woman's requirements.

[MeSH-major] Estrogen Replacement Therapy. Menopause

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(PMID = 1476898.001).

[ISSN] 0029-6570

[Journal-full-title] Nursing standard (Royal College of Nursing (Great Britain) : 1987)

[ISO-abbreviation] Nurs Stand

[Language] eng

[Publication-type] Journal Article

[Publication-country] ENGLAND

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] HRT and osteoporosis.

Hormone replacement therapy is well documented to reduce the increased bone turnover induced by oestrogen deficiency and, as a result, it prevents bone loss after the menopause.

There is a dose threshold effect, the duration of therapy influences the degree of benefit and, after the cessation of HRT, postmenopausal bone loss resumes.

Women take HRT for many reasons, most for relief of menopausal symptoms, and 10-20% show poor compliance.

The nature of HRT preparations is discussed and the current understanding of benefits and risks described.

[MeSH-major] Estrogen Replacement Therapy. Osteoporosis, Postmenopausal / prevention & control

MedlinePlus Health Information. consumer health - Osteoporosis.

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(PMID = 8293488.001).

[ISSN] 0950-3579

[Journal-full-title] Baillière's clinical rheumatology

[ISO-abbreviation] Baillieres Clin Rheumatol

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] ENGLAND

[Number-of-references] 75