WHERE ARE WE NOW? [in Menopause - Hormones and Cancer Proceedings]
edited by M. Neves -e-Castro and B.G. Wren 2002
[CH 16 p141-145]

1. Large retrospective and prospective epidemiological studies have reported that:
   
   
   1. With HRT for 10 years there are only six more cases of breast cancer diagnosed per 1000 women. This increased annual risk is equivalent to one year of delayed menopause after the age of 50 that is observed in women who have never used HRT.
      
   2. For the same 10 year treatment with HRT, it is likely that six cardiovascular events may be averted.
      
   3. HERS study (Heart and Estrogen/progestin Replacement Study) concluded it was not advisable to adopt HRT for the secondary prevention of cardiovascular events. The protective role of estrogens had no solid support.
      
   4. The opposite was seen in the Nurses Health Study (Grodstein and colleagues), which indicate that estrogens have a clear benefit for primary prevention of heart disease.
      
   5. "Unfortunately, many of these studies are biased, misinterpreted and misquoted." The patient populations are also different.
      
      
2. "The benefits [of menopausal hormones] are clear in the short and long term, not necessarily for every woman, but certainly for most of them... Estrogens are probably the only available molecules having nerve growth activity at the central nervous system level in addition to enhancing the activity of many neurotransmitters. Also, they offer protection against colon cancer, they stimulate synthesis of nitrous oxide in the vascular endothelium, and may act as calcium channel blockers, they prevent oxidation of low-density lipoprotein cholesterol and stimulate the production of high density lipoprotein, and they stimulate osteoblasts and decrease the activity of osteoclasts. Finally, they are not harmful if properly monitored for potential, though rare, side effects."
   
   

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