Hormone Replacement (Therapy): A Time for Interrogation, Information and Further Studies
The treatment of menopause relies mainly upon the use of estrogens to alleviate climacteric symptoms, increase bone mass, and consequently, potentially improve quality of life. Although a great deal of experimental data supports the beneficial effects of estrogen treatments on (arterial) cardiovascular prevention and brain function, it was recently discovered that some of the doses used, as well as certain routes of administration or different combinations with varying forms and doses of progestins, could increase the risk of cardiovas-cular events, breast cancer, and even dementia. The current literature clearly demonstrates the major controversy of administering hormone replacement therapy to women with increased risk of breast cancer and arterial cardiovascular complications because of their age notwithstanding the further risk due to some comorbid risk factors such as diabetes, high blood pressure, hyperlipidemia, etc. At this stage in our knowledge, a profound gap still exists between our hope, experimental information, and evidence-based medicine. Until this gap is closed or corrected, physicians must be very critical in their use of Hormone Replacement (HR), and use minimal doses in selected volunteer women that demand such a treatment to alleviate symptoms.
KeywordsHormone Replacement Therapy Vasomotor Symptom Conjugated Equine Estrogen Bone Mass Density Climacteric Symptom
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