Hormone Replacement Therapy and Menopause: A Review of Randomized, Double-Blind, Placebo-Controlled Trials

Chueh Chang, Catherine Hui-Wen Lin
2003 Kaohsiung Journal of Medical Sciences  
Hormone replacement therapy (HRT) is frequently prescribed to healthy women to ameliorate menopausal symptoms. HRT is used long term (≥ 1 year) to prevent chronic disease in older women. The objective of this study was to review the benefits and risks of HRT and studies of menopause or HRT in Taiwan via a MEDLINE search. Recommendations are provided for future HRT research in Taiwan. Randomized, double-blind, placebo-controlled clinical trials are considered the gold standard of scientific
more » ... of scientific evidence. A MEDLINE literature search (January 1966-July 2002) identified 23 papers on trials (≥ 1 year) that met the inclusion criteria. The results showed that various HRT regimens used for more than 1 year caused more harm than good in healthy menopausal women and that there was no benefit for women with coronary artery disease, Alzheimer's disease, hysterectomy, hysterosalpingooophorectomy, and ischemic stroke. None of this research was conducted in Taiwan. A MEDLINE search using the key words "estrogen replacement therapy and menopause in Taiwan" identified 16 studies. There was only one, short-term, HRT trial. No evidence suggested benefits from long-term HRT in menopausal women in Taiwan. Hormone replacement therapy (HRT) is frequently prescribed to healthy women as a preventative measure. Short-term (< 1 year) HRT use to ameliorate menopausal symptoms has been reported [1]. Healthy women also take long-term HRT with the purpose of preserving their health and to prevent disease [2] . women aged 50 to 79 years received one tablet of conjugated equine estrogens (CEE, 0.625 mg) plus medroxyprogesterone (MPA, 2.5 mg) or placebo. The trial was stopped after a mean of 5.2 years (planned follow-up, 8.5 years) because the risks outweighed the benefits. The WHI writing group cautioned that the combination used in the trial should not be initiated or continued. This step reveals the conscientiousness and integrity of the researchers. BMD = bone mineral density; CVD = cardiovascular disease.
doi:10.1016/s1607-551x(09)70472-3 pmid:12873034 fatcat:xd6srpu2pbcn5ijlmlwckhh46e