Risks and benefits of hormone therapy: has medical dogma now been overturned?

Shapiro, Samuel; Villiers, T. J. de; Pines, Amos; Sturdee, David W.; Baber, Rod; Panay, Nick; Stevenson, John C.; Mueck, Alfred O.; Burger, Henry G.

doi:10.3109/13697137.2014.905529

Cited by 18 publications

(7 citation statements)

References 19 publications

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“…This review does not address the known risks of some forms of MHT nor the other known benefits of this therapy. Treatment advice should be provided on an individual basis, depending on the presence of symptoms and evaluation of potential adverse cardiovascular risk [101][102][103] .…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk assessment in women – an update

et al. 2016

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Cardiovascular disease is the leading cause of morbidity and mortality in postmenopausal women. Although it is a disease of aging, vascular disease initiates much earlier in life. Thus, there is a need to be aware of the potential to prevent the development of the disease from an early age and continue this surveillance throughout life. The menopausal period and early menopause present an ideal opportunity to assess cardiovascular risk and plan accordingly. Generally in this period, women will be seen by primary health-care professionals and non-cardiovascular specialists. This review addresses female-specific risk factors that may contribute to the potential development of cardiovascular disease. It is important for all health-care professionals dealing with women in midlife and beyond to be cognisant of these risk factors and to initiate female-specific preventative measures or to refer to a cardiovascular specialist.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular risk assessment in women – an update

et al. 2016

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“…It has been widely accepted that the use of exogenous estrogens influence the development of endometriosis as well as endometrial cancer. This effect appears to be less if estrogens use along with progestagens [ 30 , 31 , 32 ]. However, progestin-only contraceptives such as medroxyprogesterone acetate (MPA) or PR agonists such as Mirena™ often cause bleeding irregularities and vaginal dryness due to complete suppression of estrogenic microenvironment in the uterus and endometrium [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

An efficient model of human endometriosis by induced unopposed estrogenicity in baboons

et al. 2016

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Endometriosis is a chronic estrogen-dependent disease that occurs in approximately 10% of reproductive age women. Baboons offer a clear benefit for studying the initiation and progression of endometriosis since baboon is very close to humans phylogenetically. Progestins are used in the treatment of endometriosis. The therapeutic window of progestins depends on the ratio of its affinity towards progesterone receptor agonism verses antagonism. The present study is to determine the role of pure antiprogestin in baboon endometriosis. We hypothesize that pure antiprogestin will induce unopposed estrogenicity and spontaneous endometriosis in baboons. The rate of endometrial invasion and attachment through modeled peritoneum in the presence and absence of progesterone and antiprogestin was evaluated in this study. A baboon model of endometriosis induced by unopposed estrogenicity using progesterone receptor antagonist (EC304) was used in this study. We observed EC304 has induced unopposed estrogenicity that deregulated proteins involved in attachment, invasion, cell growth, and steroid hormone receptors in this model. Our data suggest that depleting progesterone levels in the endometrium will increase estrogen hyper-responsiveness that leads to increased endometriotic lesion progression in the baboon (Papio anubis) model. This study reports a refined model of human endometriosis in baboons that could potentially be used to develop new diagnostic and therapeutic strategies for the benefit of women suffering from endometriosis.

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“…Importantly, both the public and the medical community appear unaware of the results published in a 2013 follow-up study with seven additional years of monitoring that reported no significant difference between HRT and placebo for mortality or a long list of other adverse events. Remarkably, although the estrogen-progesterone arm did show a minor increase in breast cancer cases compared with placebo, breast cancer cases were significantly reduced by more than 20% in women who received estrogen treatment alone (no progesterone) compared with those who received placebo [6]. To this day, it is taught to medical students and trainees that the WHI showed estrogen increases the risk of invasive breast cancer even though this reverses the actual results.…”

Section: Does Medical Hysteria Exist?mentioning

confidence: 97%

“…As pointed out by Shapiro et al, "We conclude that over-interpretation and misrepresentation of the findings in the WHI study have resulted in major damage to the health and well-being of menopausal women". The WHI was not "a victory for women and their health" [6], and the claim that the findings "do not support the use of this therapy for chronic disease prevention" is not defensible. Nor can the pejorative editorial statement that "the WHI overturned medical dogma regarding menopausal [HT] be defended".…”

Section: Who Shoulders the Responsibility?mentioning

confidence: 98%