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PubMed1977

Oestrogen excretion and ovarian pathology in postmenopausal women with atypical hyperplasia, adenocarcinoma and mixed adenosquamous carcinoma of the endometrium.

Urinary oestrogen and pregnanediol excretion were measured before and after hysterectomy and bilateral salpingo-oophorectomy in 26 postmenopausal women with adenocarcinoma of the endometrium, 10 postmenopausal women with mixed adenosquamous carcinoma and 11 postmenopausal women with atypical hyperplasia (the patient groups). The results were compared with the values obtained in 22 active postmenopausal women, 20 hospitalized postmenopausal women and 18 women who had been subjected to hysterectomy and bilateral salpingo-oophorectomy for cancer of the cervix (the control groups). The ovaries and Fallopian tubes obtained at operation were examined for evidence of current or past excessive oestrogen production. Preoperative oestrogen values were higher in the patient groups than in the controls and the elevated values persisted after oophorectomy. The implications of these findings are discussed.

Adenocarcinoma↗

PubMed1993

Endometrial changes in postmenopausal women treated with tamoxifen for breast cancer.

OBJECTIVE: To evaluate whether risk factors, other than tamoxifen, can be identified for the development of endometrial pathologies in postmenopausal breast cancer patients treated with tamoxifen. DESIGN: A cross-sectional study. SETTING: Department of Obstetrics and Gynaecology and Oncology Clinic, Sapir Medical Center, Kfar Saba, Israel. SUBJECTS: 77 asymptomatic postmenopausal women, treated with tamoxifen for breast cancer. Of these, 55 had no endometrial tissue and 22 had endometrial tissue obtained by biopsy. MAIN OUTCOME MEASURES: Demographic characteristics, health habits, risk factors, vaginal ultrasonographic evaluations of endometrial thickness and texture, and histologic evaluations of endometrial biopsies. RESULTS: Overall, there was a high rate (29%) of endometrial pathological change among the 77 asymptomatic postmenopausal women. There were no significant statistical differences in the features tested between the two groups. CONCLUSION: It is impossible to predict which postmenopausal women will develop pathological endometrial changes after treatment with tamoxifen and thus a routine periodic endometrial sampling-follow up is suggested for all postmenopausal women being treated with this agent.

Aged↗

PubMed2006

Effect of reproductive factors and postmenopausal hormone use on the risk of amyotrophic lateral sclerosis.

OBJECTIVE: To examine the associations of reproductive factors and postmenopausal hormone use with the risk of amyotrophic lateral sclerosis (ALS) among women. METHODS: This case-control study was conducted within the Kaiser Permanente Medical Care Program (KPMCP) of Northern California during the years 1996-2000. Among the 193 postmenopausal women, 62 were incident ALS cases and 131 were controls randomly selected from KPMCP members and frequency matched by age and respondent type (self versus proxy) to the cases. Statistical analyses were carried out using logistic regression. RESULTS: Reproductive factors such as age at menarche, age at final menstrual period, parity, oral contraceptive use, and type of menopause (natural vs. hysterectomy with or without oophorectomy) were not associated with risk of ALS. Postmenopausal hormone use was positively, but not significantly, associated with the risk of ALS (adjusted OR 1.9, 95% CI 0.9-3.8). CONCLUSIONS: Reproductive factors were not associated with ALS risk. There is no evidence that suggests a protective effect of postmenopausal hormone use against the development of ALS. However, due to insufficient power, we cannot rule out a possible increase in ALS risk associated with postmenopausal hormone use.

Aged↗

PubMed1995

Endocrine function of the peri- and postmenopausal ovary.

The concentration of sex steroids in peripheral and ovarian venous blood was measured in 130 perimenopausal women. We found that the postmenopausal ovary continues to secrete a large amount of testosterone and a moderate amount of androstenedione, estrone, and dehydroepiandrosterone. Although the mean estradiol levels in the ovarian vein of postmenopausal women was low, a few subjects showed estradiol levels higher than 50 pg/ml. Postmenopausal ovaries probably continue to secrete estradiol under some endocrine conditions. These data show that the postmenopausal ovary maintains some secretory function related to estrone and estradiol. However, the endocrine effect of the postmenopausal ovary may be related to its contribution of androgens to the plasma pool of estrogens through extragonadal conversion.

Adult↗

PubMed1990

Hormone receptors in pubic skin of premenopausal and postmenopausal females.

Various functions of the skin are hormone-dependent. Recently hormonal involvement in aging processes of the skin has attracted increasing interest. The rapid onset of aging of the skin from the climacterium on seems to be correlated with the decrease of estrogens. In order to evaluate hormonal stimulability of the skin a study of hormone receptors was performed in pre- and postclimacteric women. Pubic skin of a total of 106 females was obtained during gynecologic operations for determination of estrogen receptors (ER), androgen receptors (AR) and gestagen receptors (PgR) by saturation analysis. In the preclimacteric group consisting of 62 females with a mean age of 39.6 +/- (SD) 6.5 years the operations were performed in the luteal phase of the menstrual cycle. The results were compared with those of 44 postmenopausal females with a mean age of 63.2 +/- 9.4 years. AR concentrations were significantly lower in the skin of postmenopausal women. 47.4% positive findings with a mean receptor level of 15.3 +/- 33.3 fmol/mg protein were to be found against 85.2% positive AR with a mean level of 31.4 +/- 20.3 fmol/mg protein in the ovulatory cycling females. These findings were of high significance. In addition, diminished PgR in the postmenopausal group were noted for incidence and mean receptor levels. PgR were positive in 18.4% with a mean level of 34.2 +/- 72.8 fmol/mg protein versus 36.3% with a mean receptor level of 34.2 +/- 72.8 in the ovulatory group. In contrast, no significant differences between ER of premenopausal and postmenopausal skin became evident. Results of hormone receptor determinations in the premenopausal and postmenopausal group with regard to the aging process are interpreted.

Adult↗

PubMed1999

Is the response of serum lipids and lipoproteins to postmenopausal hormone replacement therapy modified by ApoE genotype?

Postmenopausal hormone replacement therapy (HRT) has favorable effects on the serum lipid profile, and it also decreases the risk of cardiovascular diseases. The apolipoprotein E genotype has influence on serum levels of lipids and lipoproteins; apoE allele epsilon4 (apoE4) is associated with high total and LDL cholesterol levels. Genotype also influences the lipid responses to treatment with diet and statins, but the effect of HRT in different apoE genotypes is unknown. We studied the effects of HRT on the concentrations of serum lipids in apoE4-positive early postmenopausal women (genotypes 3/4 and 4/4) compared with apoE4-negative women (genotypes 2/3 and 3/3) in a population-based, prospective 5-year study. In all, 232 early postmenopausal women were randomized into 2 treatment groups: an HRT group (n=116), which received a sequential combination of 2 mg estradiol valerate (E2Val) from day 1 to 21 and 1 mg cyproterone acetate (CPA) from day 12 to 21 (Climen), and a placebo group (n=116), which received 500 mg/d calcium lactate. Serum concentrations of total, LDL, and HDL cholesterol and triglycerides were measured at baseline and after 2 and 5 years of treatment. A total of 154 women completed the final analysis. During the follow-up period, serum total cholesterol and LDL cholesterol concentrations decreased in the HRT group in apoE4-negative women (8.1% and 17.1%, respectively; P<0.001) but did not change in the HRT group in apoE4-positive women or in the placebo group. Serum HDL cholesterol concentrations decreased in the placebo group (apoE4-negative, 3.9%, P=0.015; apoE4-positive, 8.1%, P=0.004) but did not change significantly in the HRT group. Serum triglyceride levels tended to increase in both study groups and genotypes (15.1% to 36.2%, P<0.038 to 0.001), but no differences were observed between the study groups or genotypes, respectively. Our finding was that in postmenopausal Finnish women LDL cholesterol levels in apoE4-negative subjects respond more favorably to HRT than those in apoE4-positive subjects. This finding has potential importance in postmenopausal women with hypercholesterolemia, if confirmed in other studies.

Apolipoprotein E4↗

PubMed1989

Relationship between whole plasma calcitonin levels, calcitonin secretory capacity, and plasma levels of estrone in healthy women and postmenopausal osteoporotics.

The exact role of calcitonin (CT) in the pathogenesis of postmenopausal osteoporosis remains unknown. Whole plasma calcitonin (iCT) basal levels, metabolic clearance rate (MCR), and production rate (PR) of CT were measured in 9 premenopausal and 16 postmenopausal women, including 11 osteoporotics (OP). Basal iCT levels were statistically lower in postmenopausal women than in the premenopausal group (P less than 0.01) and strongly correlated (r = 0.72; P less than 0.001) with estrone circulating levels (E1). MCR were similar in all groups. PR were similar in eugonadal women between 22 (mean +/- SD = 30.9 +/- 9.9 micrograms/d) and 37 yr (mean +/- SD = 25.5 +/- 11.1 micrograms/d) premenopausal women. In healthy postmenopausal women PR were reduced, but not significantly (mean +/- SD = 19.5 +/- 6.95 micrograms/d), whereas osteoporotic patients presented a highly significant reduction of CT PR (mean +/- SD = 9.8 +/- 4 micrograms/d) (P less than 0.01). Because there is a strong relationship between E1 and PR (r = 0.64; P less than 0.001), CT secretory capacity appears to be modulated by estrogen circulating levels. This modulation leads to a menopause-related decrease in iCT. In osteoporotics, an independent impairment of CT production drastically lowers PR and basal iCT levels. CT might be one of the determining factors in the pathogenesis of postmenopausal osteoporosis.

Adult↗

PubMed1976

Serum 17 beta-estradiol and estrone levels in postmenopausal women with and without endometrial cancer.

Serum 17 beta-estradiol (E2) and estrone (E1) levels were measured before and 6-8 weeks after ovariectomy in 16 postmenopausal women with endometrial cancer, and in 10 postmenopausal women with normal endometrium (preovariectomy only). For E2, no significant difference in the mean baseline (+/-SE) level was found between the tumor (13.5 +/- 1.1 pg/ml) and non-tumor patients (11.7 +/- 1.4 pg/ml). For the same patients, the mean baseline E1 levels of 33.8 +/- 2.4 pg/ml and 28.5 +/- 4.7 pg/ml were also not significantly different. The mean body weight of the tumor patients (141.1 +/- 7.3 lbs.) was similar to the mean weight of the non-tumor subjects (137.5 +/- 6.3 lbs.). This was of importance since both E2 and E1 levels correlated significantly with body weight and excess fat in these postmenopausal women. The circulating estrogen levels did not correlate significantly with the patients' height, age, or years of menopause. In the patients with endometrial cancer the mean E2 (14.1 +/- 1.7 pg/ml) and E1 (39.5 +/- 7.3 pg/ml) levels after ovariectomy were not significantly different from the preoperative concentrations. These data are consistent with the concept that in postmenopausal women most, if not all, circulating estrogen is produced by peripheral conversion of androgens and that this conversion is influenced by obesity. Circulating estrogen levels are not significantly different in postmenopausal patients with endometrial cancer compared with women of a similar age and weight who do not have the tumor.

Adenocarcinoma↗

PubMed1977

The influence of severe illness on gonadotropin secretion in the postmenopausal female.

Severe weight loss in amenorrheic premenopausal women may significantly depress gonadotropin secretion. Gonadotropin leves were studied in 111 postmenopausal women to determine if weight loss and cachexia could similarly affect gonadotropin function. Thirty-three healthy ambulatory postmenopausal women and twenty-seven healthy hospitalized women admitted electively were found to have a wide range of elevated values, whose mean did not differ significantly. Mean levels for both LH and FSH were significantly suppressed (P less than .005) in severely ill postmenopausal women both with or without weight loss. (formula: see text) Recovety from illness in six patients was associated with a rapid rise in FSH levels while LH remained depressed. Two severely ill patients studied over a 6 h period revealed constant depression of both gonadotropins without the characteristic pulses seen in four normal control postmenopausal women. These results indicate that gonadotropin secretion may be suppressed in severely ill postmenopausal women whether weight loss is present of not, and the central nervous regulatory mechanism responsible for intermittant release of gonadotropins is impaired. The disparate FSH and LH recovery indicates that if separate gonadotrophs exist, the LH gonadotroph is more severely affected than the FSH gonadotroph and/or that the responsible regulatory mechanisms are different.

Aged↗

PubMed1988

Differences in low density lipoprotein subfractions and apolipoproteins in premenopausal and postmenopausal women.

Postmenopausal or oophorectomized women are at higher risk for the development of coronary artery disease than are premenopausal women. These differences in risk may be due to alternations in plasma lipoproteins modulated by hormonal changes. Plasma cholesterol, triglyceride, lipoprotein cholesterol, and apolipoprotein A-I and B (apoB) concentrations, as well as low density lipoprotein (LDL) particle size (LDL 1-7), as assessed by 2-16% polyacrylamide-agarose gradient gel electrophoresis, were determined in 87 premenopausal and 43 postmenopausal women. All were participants in the Framingham Offspring Study, were gynecologically normal, and were not taking any hormones. The postmenopausal women had significantly (P less than 0.05) higher plasma LDL cholesterol concentrations than did the premenopausal women. Plasma triglyceride, total cholesterol, very low density lipoprotein cholesterol, and apoB levels were higher, and apoA-I and high density lipoprotein cholesterol were lower in the postmenopausal group, but these differences were not significant at P less than 0.05. The postmenopausal women were likely to have small LDL particles compared to premenopausal women. Controlling for age and body mass index effects significantly reduced the differences in total cholesterol, LDL cholesterol, apoB, and LDL particle size and broadened the differences in apoA-I and high density lipoprotein cholesterol. These data indicate that menopause is positively correlated with LDL cholesterol (P less than 0.05) and decreased LDL particle size (P less than 0.05) after adjusting for significant covariates.

Aging↗

PubMed1991

A therapeutic dilemma: suppressive doses of thyroxine significantly reduce bone mineral measurements in both premenopausal and postmenopausal women with thyroid carcinoma.

We measured lumbar spine, femoral neck, and forearm bone mineral (BMD) in 24 women (14 premenopausal and 10 postmenopausal) who had been treated with total thyroidectomy and 131 Iodine ablation therapy for nonanaplastic thyroid carcinoma and 24 case controls. At the time of the study, all patients were free of cancer (negative 131 Iodine whole body scan and serum thyroglobulin levels less than 0.3 micrograms/L) and all were receiving doses of T4 sufficiently high to prevent a rise in a serum thyroid-stimulating hormone concentration after an iv bolus of TRH. Femoral neck BMD were significantly reduced in both the premenopausal women (89 +/- 3.8% of case controls, 95% CI, 81 to 98) and postmenopausal women (77 +/- 3.9% of case controls; 95% CI, 68 to 86) receiving T4. Lumbar spine BMD and forearm BMD were unaffected in the premenopausal women, but significantly reduced in the postmenopausal women receiving T4 (lumbar spine BMD = 84 +/- 6.2% of case controls; 95% CI, 70 to 98 and forearm BMD = 89 +/- 5.6% of case controls; 95% CI, 76 to 101). Serum bone Gla-protein, a marker of bone turnover, was significantly increased in both the premenopausal and the postmenopausal women receiving T4 compared to case controls (P less than 0.001 for the difference between patient groups and controls). Whereas the cumulative dose of T4 was highly correlated with the femoral neck BMD in the premenopausal patients (r = 0.528; P less than 0.05); the presence of hypogonadism was the main determinant of the lumbar spine and forearm BMD. This data confirms that premenopausal and postmenopausal women receiving suppressive doses of T4 for thyroid carcinoma have diminished bone mineral measurements and are at risk for osteoporosis.

Adult↗

PubMed2003

Effects of hormone replacement therapy on circulating docosahexaenoic acid and eicosapentaenoic acid levels in postmenopausal women.

Hormone replacement therapy (HRT) has antiatherosclerotic effects of which the mechanism remains unclear. The ingestion of fish oil or other sources of n-3 polyunsaturated fatty acids has been included in comprehensive strategies to prevent atherosclerosis. Many epidemiologic studies have shown that the dietary intake of docosahexaenoic acid and eicosapentaenoic acid has antiatherosclerotic effects. We investigated the effect of HRT on plasma docosahexaenoic acid and eicosapentaenoic acid concentrations in postmenopausal women. Fifty-nine postmenopausal women, who received conjugated estrogens (0.625 mg/day) and medroxyprogesterone (2.5 mg/day) for 12 months, and 45 control postmenopausal women, who did not receive HRT, volunteered to participate in this study. Plasma docosahexaenoic acid and eicosapentaenoic acid concentrations were measured at baseline and at 6 and 12 months after the start of HRT. HRT significantly increased the plasma docosahexaenoic acid and eicosapentaenoic acid concentrations from 134 +/- 5 microg/ml and 69 +/- 4 microg/ml at baseline to 156 +/- 7 microg/ml and 85 +/- 7 microg/ml after 12 months (both p<0.01). However, the control group showed no significant change in their plasma docosahexaenoic acid and eicosapentaenoic acid levels during the study. HRT increased plasma docosahexaenoic acid and eicosapentaenoic acid levels in postmenopausal women. We propose that the increase in docosahexaenoic acid and eicosapentaenoic acid may be partially responsible for the beneficial mechanisms by which HRT induces an antiatherosclerotic effect in postmenopausal women.

Adult↗

PubMed1987

Exposure-dependent effects of ethanol on serum estradiol and uterus mass in sexually mature oophorectomized rats: a model for bilaterally ovariectomized-postmenopausal women.

Factors that may affect the estrogenization of postmenopausal women are important because estrogen levels may modulate the risk of osteoporosis and cardiovascular disease in postmenopausal women. Ethanol, a potential estrogenization factor, has received scant attention, particularly in postmenopausal women who are moderate users of alcoholic beverages. Because as many as 22.6% of postmenopausal women are reported to have had a bilateral oophorectomy, mature oophorectomized rats were used as a model. Low to moderate ethanol consumption was approximated by administering graded doses of ethanol in drinking water (0, 1.8, 3.7 or 5.5% ethanol, v/v) to 90 oophorectomized rats for 4 or 10 weeks. In rats exposed for 4 weeks, neither estradiol levels nor uterus weight differed among the four groups. In contrast, among rats exposed for 10 weeks, there was a significant positive correlation between ethanol dose and both uterus weight and estradiol; analysis of variance demonstrated that inclusion of the data obtained from rats receiving the 5.5% ethanol dose accounted for the significance of these associations. Based on these findings, it is suggested that, at least in oophorectomized rats, prolonged exposure to moderate ethanol doses is required to induce sufficient aromatization of androgens to produce detectable changes in plasma estradiol or in uterus weight. Further studies will be required to determine whether low or moderate alcoholic beverage use by postmenopausal women may result in biologically relevant increases in serum estradiol.

Animals↗

PubMed1990

Human chorionic gonadotrophin-like and beta-core-like materials in postmenopausal urine.

In addition to human chorionic gonadotrophin (hCG), the urine of pregnant women contains a small molecular weight form of the hCG-beta subunit known as beta-core. Human CG-like material has been described in tissues, serum and urine of normal man, particularly in postmenopausal women. We examined different urine preparations from postmenopausal women to determine whether beta-core-like material, as well as hCG-like material, could be detected. We studied an acetone extract of a pool of 11 litres of postmenopausal urine, three different commercial preparations of human menopausal gonadotrophins and two commercial preparations of 'pure' FSH. After Sephadex G-100 chromatography of these various postmenopausal urine extracts, fractions were assayed using four assay systems to detect hCG, beta-core, LH and FSH immunoreactivities. Human CG immunoreactivity was readily detected in all urinary extracts and it eluted in a position indistinguishable from that of purified hCG. In addition to this hCG-like material, all urinary extracts, except the commercial 'pure' FSH preparations, contained material which reacted in the beta-core radioimmunoassay. This beta-core immunoreactive material eluted from Sephadex G-100 in a position corresponding to that of purified pregnancy-derived beta-core. We conclude that the urine of postmenopausal women contains material resembling the beta-core molecule found in pregnancy urine. The origin of this beta-core-like material remains to be determined, and its presence will have an impact on the application of urinary beta-core as a tumour marker.

Chorionic Gonadotropin↗

PubMed1991

The purification and development of a radioimmunoassay for beta-core fragment of human chorionic gonadotrophin in urine: application as a marker of gynaecological cancer in premenopausal and postmenopausal women.

The beta-core fragment of human chorionic gonadotrophin (hCG) is a major part of the immunoreactive hCG-like material found in the urine of normal pregnant women. Patients with non-trophoblastic gynaecological malignancies have been found to have raised levels of urinary beta-core. We describe the purification of beta-core, the preparation of a polyclonal sheep antiserum and the development of radioimmunoassay. The minimum detection limit of this assay was 0.025 micrograms beta-core/l. There was no significant cross-reaction with the free alpha-subunit, hLH, hFSH and hTSH (less than 0.7%), and only partial cross-reaction with intact hCG and free beta-subunit of hCG (6.9 and 18%). Within-assay variability ranged from 2.03 to 12.5% and between-assay variability from 2.25 to 13.4%. The assay was applied to urine samples from 92 normal non-pregnant premenopausal women, 54 normal postmenopausal women and 65 women with active gynaecological disease (47 postmenopausal and 18 premenopausal). In normal premenopausal women the values ranged from less than 0.025 to 0.62 micrograms beta-core/l (median 0.043 micrograms beta-core/l). The values for normal postmenopausal women ranged from less than 0.025 to 0.64 micrograms beta-core/l (median 0.26 micrograms beta-core/l). Postmenopausal women with gynaecological malignancy had values which ranged from less than 0.025 to 4.0 micrograms/beta-core/l (median 0.31 micrograms beta-core/l); premenopausal women in this group had values which ranged from less than 0.025 to 1.15 micrograms beta-core/l (median 0.12 micrograms beta-core/l). On molecular sieve chromatography, the material found in the urine of normal postmenopausal women showed the physicochemical characteristics of authentic beta-core.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

Peripheral and ovarian venous concentrations of estradiol and progesterone in postmenopausal women with "non-endocrine" ovarian tumors.

Estradiol (E2) and progesterone (P4) levels in peripheral venous blood were measured in 45 postmenopausal (more than 5 years after menopause) women with ovarian neoplasms. The E2 and P4 concentrations in ovarian venous blood were also measured in 26 of these 45 patients. The steroid levels were compared with the values in 10 postmenopausal women without ovarian tumors. In peripheral venous blood, relatively high E2 concentrations were found in 24 of the 45 (53%) postmenopausal patients with ovarian tumors, and relatively high P4 concentrations were noted 15 of 45 (33%) of the patients. In ovarian venous blood, relatively high values of E2 were found in 18 of 26 (69%) of the postmenopausal patients, and relatively high values of P4 were noted in 11 of these 26 (42%). No differences in the E2 and P4 levels in peripheral and ovarian venous blood were noted between the patients with benign tumors and those with malignant tumors. These results suggest that some of the epithelial ovarian tumors in postmenopausal women have steroid-producing activity.

Estradiol↗

PubMed1995

Postmenopausal estrogen therapy and the risk for developing systemic lupus erythematosus.

OBJECTIVE: To examine the relation between postmenopausal hormone use and development of systemic lupus erythematosus. DESIGN: Prospective cohort study. SETTING: Nurses' Health Study. PATIENTS: 69,435 women aged 30 to 55 years in 1976 who reported that they had completed menopause and did not have systemic lupus erythematosus or any connective tissue disease were followed every 2 years from 1976 to 1990. These women were classified as never- or ever-(current and past) users of postmenopausal hormones. MEASUREMENTS: Incidence rates of systemic lupus erythematosus and classification criteria from the American College of Rheumatology that were confirmed by chart review. RESULTS: With never-users of postmenopausal hormones as the reference group, age-adjusted relative risks for systemic lupus erythematosus (n = 45 women) were 2.1 (95% CI, 1.1 to 4.0) for ever-users, 2.5 (CI, 1.2 to 5.0) for current users, and 1.8 (CI, 0.8 to 4.1) for past users. A proportional increase in the risk for systemic lupus erythematosus was observed that was related to the duration of use of postmenopausal hormones (test for trend, P = 0.011). CONCLUSIONS: Postmenopausal hormone therapy is associated with an increased risk for developing systemic lupus erythematosus.

Adult↗

PubMed2004

Changes in the use of postmenopausal hormone therapy after the publication of clinical trial results.

BACKGROUND: The recent publication of clinical trial results has led to a dramatic shift in the evidence about postmenopausal hormone therapy. OBJECTIVE: To examine whether the publication of clinical trial results, specifically the Heart and Estrogen/progestin Replacement Study (HERS) in 1998 and the Women's Health Initiative (WHI) in 2002, has influenced the use of hormone therapy among postmenopausal women. DESIGN: Observational cohort (1997 to 2003). SETTING: San Francisco Mammography Registry, San Francisco, California. PARTICIPANTS: Postmenopausal women between the ages of 50 and 74 years without a personal history of breast cancer who underwent mammography (151862 mammograms). MEASUREMENTS: Self-reported current use of hormone therapy. RESULTS: Among menopausal women who had mammography, it was estimated that 41% were currently using hormone therapy in 1997. Before the publication of HERS, the use of hormone therapy was increasing at a rate of 1% (95% CI, 0% to 2%) per quarter. After the publication of HERS, use decreased by 1% (CI, -3% to 0%) per quarter. In contrast, the publication of the WHI in 2002 was associated with a more substantial decline in the use of hormone therapy of 18% (CI, -21% to -16%) per quarter. Similar associations were observed for most subgroups of women, including women older than 65 years of age; women with a previous hysterectomy; and women who described their race or ethnicity as white, African American, Latina, Chinese, or Filipina. CONCLUSIONS: The release of the HERS data was temporally associated with a modest decline in the use of hormone therapy. In contrast, the release of the principal findings from the WHI was associated with a more substantial decline in use by postmenopausal women. The reason for the differences in decline may relate to the fact that the WHI results were widely publicized or were more applicable to most postmenopausal women because the WHI study was performed in healthy women.

Age Factors↗