Replacement

Female Reproductive System & Breast


HRT usage in hot flashes

HRT remains the first line treatment for hot flashes and other vasomotor symptoms related to menopause.

Women who additionally suffer from sleep or psychiatric disturbances may require treatment with psychotropics in conjunction with HRT.

HRT risks and benefits

HRT carries manifold risks and benefits; with respect to the former, it is known to decrease the risk of certain diseases such as colon cancer, dementia, and osteoporosis.

Conversely, these patients are at increased risk for breast and endometrial cancer, thromboembolism, and ischemic stroke; regular screening in this respect is thus important.

Postmenopausal symptoms

Post-menopausal syndrome is a set of symptoms that occurs around and after the time of onset of menopause. These include mood lability, hot flashes, sexual dysfunction, UTIs, vaginal atrophy, osteoporosis and sleep disturbances.

Natural vs. synthetic progestogens and breast cancer

Despite evidence in support of the notion that progesterone is largely responsible for the risk of breast cancer, research suggests that the type of progesterone used may influence the degree of this risk.

In fact, synthetic progestins have been found to be responsible for increasing the risk of the disease while natural progesterone is considered to be safe.

References

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  2. Hormone replacement therapy and endometrial cancer risk: A meta-analysis. International Journal of Gynecology & Obstetrics [online] 1995 October [viewed 16 July 2016] Available from: doi:10.1016/0020-7292(95)80037-D
  3. Reorganized text. JAMA Otolaryngol Head Neck Surg [online] 2015 May 1, 141(5):428 [viewed 16 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/25996397
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  5. BERAL V, BULL D, REEVES G, MILLION WOMEN STUDY COLLABORATORS. Endometrial cancer and hormone-replacement therapy in the Million Women Study. Lancet [online] 2005 Apr 30-May 6, 365(9470):1543-51 [viewed 16 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/15866308
  6. BRINTON LA, FELIX AS. Menopausal hormone therapy and risk of endometrial cancer. J Steroid Biochem Mol Biol [online] 2014 Jul:83-9 [viewed 16 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/23680641
  7. OEFFINGER KC, FONTHAM ET, ETZIONI R, HERZIG A, MICHAELSON JS, SHIH YC, WALTER LC, CHURCH TR, FLOWERS CR, LAMONTE SJ, WOLF AM, DESANTIS C, LORTET-TIEULENT J, ANDREWS K, MANASSARAM-BAPTISTE D, SASLOW D, SMITH RA, BRAWLEY OW, WENDER R, AMERICAN CANCER SOCIETY. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA [online] 2015 Oct 20, 314(15):1599-614 [viewed 18 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/26501536
  8. PACI E, EUROSCREEN WORKING GROUP. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet. J Med Screen [online] 2012:5-13 [viewed 18 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/22972806
  9. JOFFE H, SOARES CN, COHEN LS. Assessment and treatment of hot flushes and menopausal mood disturbance. Psychiatr Clin North Am [online] 2003 Sep, 26(3):563-80 [viewed 22 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/14563098
  10. SASSARINI J, LUMSDEN MA. Hot flushes: are there effective alternatives to estrogen? Menopause Int [online] 2010 Jun, 16(2):81-8 [viewed 22 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/20729500
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  12. HANEY AF, WILD RA. Options for hormone therapy in women who have had a hysterectomy. Menopause [online] 2007 May-Jun, 14(3 Pt 2):592-7; quiz 598-9 [viewed 18 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/17476150
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HERRINTON LJ, WEISS NS. Postmenopausal unopposed estrogens. Characteristics of use in relation to the risk of endometrial carcinoma. Ann Epidemiol [online] 1993 May, 3(3):308-18 [viewed 16 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/8275205

  1. CAMPAGNOLI C, CLAVEL-CHAPELON F, KAAKS R, PERIS C, BERRINO F. Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. J Steroid Biochem Mol Biol [online] 2005 Jul, 96(2):95-108 [viewed 18 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/15908197]
  2. LAWLOR DA, SMITH GD. Cardiovascular risk and hormone replacement therapy. Curr Opin Obstet Gynecol [online] 2006 Dec, 18(6):658-65 [viewed 18 July 2016] Available from: http://www.ncbi.nlm.nih.gov/pubmed/17099339