Risks and Benefits of Estrogen plus Progestin in Healthy Postmenopausal

For reasons both practical and political, women’s health has long been neglected as a field of study. This study by the Women’s Health Initiative is the largest investigation of a pertinent women’s issue ever, with 161,809 post-menopausal women enrolled from 1993 to 1998. Designed in the early part of the 1990s, this study consisted several trials, among them low-fat dietary patterns, calcium and vitamin D supplement use, and hormone replacement therapy. The hormone replacement trial experienced such surprising and unpredicted results that the entire trial was stopped early. It was hypothesized that giving post-menopausal women a combination of estrogen and progesterone would prevent coronary heart disease. Thus, a coronary heart disease event such as a heart attack was considered the primary outcome, or stopping point. Intermediate markers were determined to be invasive breast cancer, stroke, pulmonary embolism, endometrial cancer, colorectal cancer, or hip fracture. Hormone replacement therapy has long been an accepted form of treatment for women with age-related diseases like osteoporosis. Thus, when the WHI realized that the women taking estrogen plus progesterone were experiencing 29% more coronary heart disease events (i.e. heart attacks), 41% more strokes, and 26% more breast cancer than those who were receiving the placebo, the study was terminated. While the group of women receiving hormones also experience 37% less colorectal cancer and lower hip fracture rates, it was determined that allowing the trial to run to its finish would not be beneficial overall and would in fact cause increasing harm for stroke, coronary heart disease, and breast cancer. Below is a list of things that were inv... ...nodes; or the cancer has spread to lymph nodes near the breastbone or to other tissues near the breast Stage IV – metastatic breast cancer where the cancer has spread outside the breast to other organs in the body Hormonal Treatments of Breast Cancer Pathologists examine the cancers in the breast for estrogen or progestin. If there are signs of either the patient may be eligible for certain drugs containing special hormones. There are also very uncommon side effects like blood clots, strokes, or uterine cancer that may scare patients from choosing to take it. Venous Thromboembolic Disease A clotting of the blood in the blood vessel associated with deep vein thrombosis and pulmonary embolism. Other Cancers Endometrial- cancer that originates in the endometrial lining of the uterus Colorectal- cancer of the colon or rectum