Hormone replacement therapy: the risks and benefits of treatment

Hardie, Catriona; Bain, C. J.; Walters, M. B.

doi:10.4997/jrcpe.2009.408

Cited by 6 publications

(5 citation statements)

References 17 publications

(21 reference statements)

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“…Fortunately, hot flashes can be effectively treated with hormone replacement therapy (HRT) . However, possible adverse effects of long term HRT have promoted the use of complementary therapies by menopausal women. Recently, soy isoflavones, black cohosh and red clover have been reported to be widely used to relieve menopausal hot flashes , but their efficacies remain largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Quantitative efficacy of soy isoflavones on menopausal hot flashes

et al. 2015

Brit J Clinical Pharma

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AIMThis study aimed to quantitate the efficacy of soy isoflavones in the treatment of menopausal hot flashes. METHODSModel based meta-analysis (MBMA) was used to quantitate the efficacy of soy isoflavones. We conducted a systemic literature search to build a time-effect model for placebo and soy isoflavones in treating menopausal hot flashes. Studies were identified, subjected to inclusion and exclusion criteria, and reviewed. RESULTSFrom 55 articles, 16 studies of soy isoflavones met the inclusion criteria, and contained 65 and 66 mean effect values in placebo and soy isoflavone groups, respectively, from about 1710 subjects. Interestingly, the developed model was found to describe adequately the time course of hot flashes reduction after administration of placebo and soy isoflavones. Using this model, we found that the maximal percentage change of hot flashes reduction by soy isoflavones was 25.2% after elimination of the placebo effect, accounting for 57% of the maximum effects of estradiol (E max-estradiol = 44.9%). However, a time interval of 13.4 weeks was needed for soy isoflavones to achieve half of its maximal effects, much longer than estradiol, which only required 3.09 weeks. These results suggest that treatment intervals of 12 weeks are too short for soy isoflavones, which require at least 48 weeks to achieve 80% of their maximum effects. CONCLUSIONSSoy isoflavones show slight and slow effects in attenuating menopausal hot flashes compared with estradiol. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Menopause hot flashes can be effectively treated with hormone replacement therapy (HRT). However, possible adverse effects of long term HRT have promoted the use of complementary therapies by menopausal women.• There has been debate on the benefits of soy isoflavones in the treatment of menopausal hot flashes. WHAT THIS STUDY ADDS• The effects of soy isoflavones on menopausal hot flashes was quantitated adequately by the model based meta-analysis. • The developed model provided the robust evidence that soy isoflavones have slight and slow effects in attenuating menopausal hot flashes compared with estradiol.

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Section: Introductionmentioning

confidence: 99%

Quantitative efficacy of soy isoflavones on menopausal hot flashes

et al. 2015

Brit J Clinical Pharma

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“…Nearly 50% of women experiencing symptoms during the menopausal transition find these symptoms distressing [1]. With conventional hormone replacement therapy (HRT) viewed as problematic by both experts and the public [2] women increasingly look for alternative solutions [3], including the use of complementary and alternative medicine (CAM) [4] [5].…”

Section: Introductionmentioning

confidence: 99%

Chinese medicine treatment for menopausal symptoms in the UK health service: Is a clinical trial warranted?

et al. 2015

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Abstract:Objectives: The aims of this pilot study were to evaluate treatment effects, ascertain safety and formulate best practice Chinese medicine protocols relevant for London women suffering from menopausal symptoms. Study Design:This clinical pilot study employed a case series design within a wider action-based research project. 117 perimenopausal women between 45-55 years of age recruited from the general population were treated for menopausal symptoms by six experienced practitioners of Chinese medicine at the Polyclinic of the University of Westminster. Practitioners were instructed to treat as near to their usual practice style as possible. This involved using Chinese herbal medicine and/or acupuncture along with dietary and lifestyle advice. A maximum of twelve treatments over six months was allowed per patient. Outcome Measures:The Menopause Specific Quality of Life Questionnaire (MenQoL), the Greene Climacteric Scale, and flushing diaries were used to evaluate treatment outcomes. Liver and kidney function tests were carried out at intake and after one, six and twelve treatments to evaluate the safety particularly in relation to the use of herbal medicines.

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“…Hormone therapy can address many of the consequences of reduced ovarian sex steroid production, however not all menopausal women are inclined to use hormone therapy due to the widely publicized controversies surrounding its benefits and risks. 5–7…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4] Hormone therapy can address many of the consequences of reduced ovarian sex steroid production, however not all menopausal women are inclined to use hormone therapy due to the widely publicized controversies surrounding its benefits and risks. [5][6][7] In reality, conjugated estrogens (CEs) have been well studied and have a favorable benefit /risk profile. 8 Treatment with CE was recently shown to have minimal risks, especially in younger menopausal women.…”

Section: Introductionmentioning

confidence: 99%

Tissue Selective Estrogen Complexes (TSECs) Differentially Modulate Markers of Proliferation and Differentiation in Endometrial Cells

et al. 2013

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Selective estrogen receptor modulators (SERMs) have tissue-specific estrogen receptor (ER) modulating properties. Combining an SERM with one or more estrogens to form a tissue selective estrogen complex (TSEC) can provide an improved blend of tissue-specific ER agonist and antagonist effects. While both estrogens and SERMs affect the uterine endometrium, not all TSECs reverse the endometrial effects of estrogens preventing endometrial proliferation and hyperplasia. Their action in uterine cells is not completely understood. HOXA 10, leukemia inhibitory factor (LIF), progesterone receptor (PR), and EMX2 are genes known to regulate endometrial proliferation and differentiation. The expression of these genes was used to assess endometrial effects of SERMs and TSECs. We evaluated the effects of raloxifene (RAL), tamoxifen (TAM), lasofoxifene (LAS), bazedoxifene acetate (BZA), and progesterone (P) alone and in combination with estradiol (E2) in Ishikawa cells. Increased HOXA10, LIF, PR, and EMX2 messenger RNA (mRNA) expression was noted in E2-treated cells compared with vehicle-treated controls. All TSECs maintained E2-induced PR expression and all except TAM prevented estrogen-induced LIF expression. The TSEC containing BZA uniquely decreased HOXA10 expression and increased EMX2 expression. The TSECs alter endometrial cell proliferation by selective modulation of estrogen responsive genes, maintaining the antiproliferative effects mediated by PR and inhibiting LIF. The differential effect of TSECs on endometrial gene expression suggests a mechanism by which they manifest differential effects on endometrial safety against the risk of estrogen-induced endometrial hyperplasia.

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Hormone replacement therapy: the risks and benefits of treatment

Cited by 6 publications

References 17 publications

Quantitative efficacy of soy isoflavones on menopausal hot flashes

Quantitative efficacy of soy isoflavones on menopausal hot flashes

Chinese medicine treatment for menopausal symptoms in the UK health service: Is a clinical trial warranted?

Tissue Selective Estrogen Complexes (TSECs) Differentially Modulate Markers of Proliferation and Differentiation in Endometrial Cells

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