“…For example, the 17HSDB1 gene polymorphisms examined in the SMWHS and SWAN studies have been associated with higher endogenous estrogen levels, thus presenting a challenge for health-care providers to prescribe safe levels of estrogen therapies for women with these polymorphisms. In addition, 17HSDB1 polymorphisms have been associated with diabetes mellitus (Lo, Zhao, Scuteri, Brockwell, & Sowers, 2006), mammographic density (Dumas & Diorio, 2010), reproductive diseases, including endometriosis (Hu et al, 2012; Tschuiya et al, 2005), and potentially to reproductive system cancers such as breast and endometrial cancer (Gaudet et al, 2008; Setiawan, Hankinson, Colditz, Hunter, & De Vivo, 2004). In order to address these issues, further research about the functional effects of these polymorphisms and symptoms and symptom clusters is needed, including the likely influence of multiple polymorphisms in the estrogen synthesis, metabolism, and receptor genes on symptoms and symptom clusters and additional health outcomes that women experience during the MT and early postmenopause.…”