Postmenopausal estrogen therapy and selected (less-often-considered) disease outcomes

To review the association between postmenopausal estrogen therapy and chronic conditions not usually considered in risk-benefit reviews.

Ten-year literature review (1989-1998) of case series and epidemiologic studies with risk estimates and 95% confidence intervals.

Osteoarthritis and rheumatoid arthritis, the most extensively studied conditions, show no consistent association with hormone therapy. Two studies of systemic lupus erythematosus show a nearly three-fold increased risk apparent after 2 or more years of hormone therapy. Single studies suggest an increased risk of pancreatitis, asthma, and Raynaud's syndrome. Evidence for a reduced risk of diabetes mellitus is not compelling. Cataracts and migraine are either increased or decreased by hormone therapy. Among the associations considered here, only an increased risk of gallbladder disease and venous thromboembolic disease have been confirmed in clinical trials of hormone replacement therapy.

Further studies are needed.