The Women's Health Initiative trial and related studies: 10 years later: A clinician's view

Estrogen Receptor Subtypes Mediate Distinct Microvascular Dilation and Reduction in [Ca2+]i in Mesenteric Microvessels of Female Rat

“…Also, earlier clinical observations suggested that climacteric women receiving E2 containing menopausal hormone therapy (MHT) to reduce menopausal symptoms have lower rates of CVD, supporting the vascular benefits of E2 (Reslan and Khalil, 2012;Gurney et al, 2014). The beneficial vascular effects of E2 have been ascribed to modification of circulating lipoproteins, inhibition of the vascular accumulation of collagen, and vasodilator effects on the endothelium and vascular smooth muscle (VSM) (Mendelsohn, 2002;Khalil, 2013).…”

“…Despite evidence from earlier clinical observations and experimental studies, randomized clinical trials in postmenopausal women with or without CVD have shown no vascular benefits from MHT (Reslan and Khalil, 2012;Gurney et al, 2014). Several factors could have contributed to the lack of vascular benefits of MHT, including preexisting CVD, the subject's age, and age-related changes in estrogen receptor (ER) amount, distribution, integrity, and post-ER signaling mechanisms (Reslan and Khalil, 2012;Gurney et al, 2014).…”

“…Several factors could have contributed to the lack of vascular benefits of MHT, including preexisting CVD, the subject's age, and age-related changes in estrogen receptor (ER) amount, distribution, integrity, and post-ER signaling mechanisms (Reslan and Khalil, 2012;Gurney et al, 2014). These observations have made it imperative to thoroughly investigate the vascular ERs, their tissue distribution in the arterial tree, and their downstream post-ER signaling mechanisms.…”

Re: ‘Previous caesarean delivery and the risk of unexplained stillbirth: retrospective cohort study and meta‐analysis’

“…benefits for the fetus and no increased risk of maternal death.' 3 Another reference misquoted by Ms Cohain 4 reports that, contrary to her assertion that low risk pregnancies are uncomplicated, a high percentage of low risk pregnancies had unexpected complications. Recommendations to support home births in 'low risk' pregnancies are therefore questionable.…”

“…Recommendations to support home births in 'low risk' pregnancies are therefore questionable. 4 Ms Cohain claims that cord prolapse is 'the only event with better outcomes in a hospital'. This is false.…”