Abstract
The adverse outcomes seen in WHI [1] were mainly due to an over-dosage of hormones in a relatively elderly population. However, fundamental differences exist between conjugated equine estrogens and 17 beta estradiol and between medroxyprogesterone acetate and natural progesterone. It is likely that these differences also contributed to the adverse outcomes in WHI, which were contrary to the cardiovascular benefits seen in previous observational trials. Recent studies of cardiovascular risk markers in younger women have been designed using predominantly estradiol and natural progesterone (transdermal and oral) as the primary interventions. This chapter reviews the effects that body identical estradiol and progesterone can have, both in the physiological environment and also when replaced as transdermal estradiol and micronized oral progesterone.
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References
Writing Group for the Women’s Health Initiative Investigators (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From Women’s Health Initiative randomized controlled trial. JAMA 288(3):321–333
Panay N, Fenton A (2010) Bioidentical hormones: what is all the hype about? Climacteric 13(1):1–3
Sitruk-Ware R (2008) Pharmacological profile of progestins. Maturitas 61(1–2):151–157
Panay N, Studd JWW (1997) Progestogen intolerance and compliance with hormone replacement therapy in menopausal women. Hum Reprod Update 3(2):159–171
Simon J (2012) What’s new in hormone replacement therapy: focus on transdermal estradiol and micronized progesterone. Climacteric 15(Suppl 1):3–10
Mueck AO (2012) Postmenopausal hormone replacement therapy and cardiovascular disease: the value of transdermal estradiol and micronized progesterone. Climacteric 15(Suppl 1):11–17
Harman SM, Brinton EA, Cedars M, Lobo R, Manson JE, Merriam GR, Miller VM, Naftolin F, Santoro N (2005) KEEPS: the Kronos early estrogen prevention study. Climacteric 8(1):3–12
Hodis HN, Mack WJ, Shoupe D, Azen SP, Stanczyk FZ, Hwang-Levine J, Budoff MJ, Henderson VW (2014) Testing the menopausal hormone therapy timing hypothesis: the early versus late intervention trial with estradiol. Circulation 130:Abstract 13283
Canonico M, Fournier A, Carcaillon L, Olie V, Plu-Bureau G, Oger E, Mesrine S, Boutron-Ruault MC, Clavel-Chapelon F, Scarabin PY (2010) Postmenopausal hormone therapy and risk of idiopathic venous thromboembolism: results from the E3N cohort study. Arterioscler Thromb Vasc Biol 30(2):340–345
Canonico M, Oger E, Plu-Bureau G, Conard J, Meyer G, Lévesque H, Trillot N, Barrellier MT, Wahl D, Emmerich J, Scarabin PY, Estrogen and Thromboembolism Risk (ESTHER) Study Group (2007) Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation 115(7):840–845
The Writing Group for the PEPI Trial (1996) Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA 275(5):370–375
Allen NE, Tsilidis KK, Key TJ et al (2010) Menopausal hormone therapy and risk of endometrial carcinoma among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition. Am J Epidemiol 172:1394–1403
Franke HR, Vermes I (2003) Differential effects of progestogens on breast cancer cell lines. Maturitas 46(Suppl 1):S55–S58
Fournier A, Fabre A, Mesrine S, Boutron-Ruault MC, Berrino F, Clavel-Chapelon F (2008) Use of different postmenopausal hormone therapies and risk of histology- and hormone receptor-defined invasive breast cancer. J Clin Oncol 26(8):1260–1268
Fournier A, Mesrine S, Boutron-Ruault MC, Clavel-Chapelon F (2009) Estrogen–progestagen menopausal hormone therapy and breast cancer: does delay from menopause onset to treatment initiation influence risks? J Clin Oncol 31:5138–5143
Kuhl H, Schneider HP (2013) Progesterone – promoter or inhibitor of breast cancer. Climacteric 16(Suppl 1):54–68
Schierbeck LL, Rejnmark L, Tofteng CL et al (2012) Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomized trial. BMJ 345:e6409
Panay N, Fenton A (2011) Has the time for the definitive, randomized, placebo-controlled HRT trial arrived? Climacteric 14(2):195–196
Villiers TJ, STRAW + 10 Collaborative Group (2012) Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Climacteric 15(2):105–114
de Villiers TJ, Pines A, Panay N, Gambacciani M, Archer DF, Baber RJ, Davis SR, Gompel AA, Henderson VW, Langer R, Lobo RA, Plu-Bureau G, Sturdee DW, International Menopause Society (2013) Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health. Climacteric 16(3):316–337
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© 2016 International Society of Gynecological Endocrinology
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Panay, N. (2016). Body Identical Hormone Replacement: The Way Forward?. In: Genazzani, A., Tarlatzis, B. (eds) Frontiers in Gynecological Endocrinology. ISGE Series. Springer, Cham. https://doi.org/10.1007/978-3-319-23865-4_24
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DOI: https://doi.org/10.1007/978-3-319-23865-4_24
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