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Menopause and post-menopause

G M Prelevic1, H S Jacobs

  • 1Department of Medicine, University College London Medical School, UK.

Bailliere'S Clinical Endocrinology and Metabolism
|July 1, 1997
PubMed
Summary
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Hormone replacement therapy, particularly estrogen therapy, offers significant benefits for post-menopausal women, reducing risks of heart disease, osteoporosis, and Alzheimer's. However, potential increased risks of breast cancer and venous thromboembolism require careful consideration.

Area of Science:

  • Endocrinology and hormone replacement therapy.
  • Cardiovascular disease prevention and menopausal health.

Background:

  • Menopause is viewed as an endocrine deficiency state.
  • Estrogen therapy aims to restore the pre-menopausal endocrine environment.

Purpose of the Study:

  • To review the effects of hormone replacement therapy (HRT) on various physiological systems.
  • To explore mechanisms of estrogen's cardioprotective effects.
  • To assess HRT's impact on bone health, Alzheimer's disease, breast cancer, and venous thromboembolism.

Main Methods:

  • Review of currently available data on estrogen therapy's effects.
  • Analysis of impacts on serum lipids, vessel wall function, cardiac function, blood pressure, hemostasis, insulin sensitivity, and direct anti-atherosclerotic effects.

Related Experiment Videos

  • Examination of effects on bone mineral density (BMD) and fracture rates.
  • Evaluation of epidemiological data and clinical trials concerning Alzheimer's disease, breast cancer, and venous thromboembolism.

    • Main Results:

    • Estrogen therapy significantly reduces cardiovascular disease morbidity and mortality by approximately 50%.
    • HRT increases bone mineral density (BMD) and decreases fracture rates in post-menopausal women.
    • Estrogen replacement reduces Alzheimer's disease incidence by 50% and shows beneficial effects on cognitive function.
    • Conflicting data exists on breast cancer risk, with some evidence suggesting increased risk after 5 years of use or in older women.
    • Risk of venous thromboembolism is highest within the first 12 months of therapy.

    Conclusions:

    • Estrogen therapy provides substantial benefits in alleviating menopausal symptoms and reducing risks of major diseases.
    • Cardioprotection is a major benefit, mediated by complex effects on lipids, the vessel wall, and cardiac function.
    • While beneficial for bone and cognitive health, potential risks for breast cancer and venous thromboembolism necessitate individualized assessment.