Faculty Articles

A heartfelt message, estrogen replacement therapy: use it or lose it.

ISBN or ISSN

0363-6135

Publication Title

American Journal of Physiology - Heart and Circulatory Physiology

Volume

315

Issue

6

Publication Date / Copyright Date

12-1-2018

First Page

1765

Last Page

1765

Publisher

American Physiological Society

DOI Number

10.1152/ajpheart.00041.2018

Abstract

The issue of cardiovascular and cognitive health in women is complex. During the premenopausal phase of life, women have healthy blood pressure levels that are lower than those of age-matched men, and they have less cardiovascular disease. However, in the postmenopausal stage of life, blood pressure in women increases, and they are increasingly susceptible to cardiovascular disease, cognitive impairments, and dementia, exceeding the incidence in men. The major difference between pre- and postmenopausal women is the loss of estrogen. Thus, it seemed logical that postmenopausal estrogen replacement therapy, with or without progestin, generally referred to as menopausal hormone treatment (MHT), would prevent these adverse sequelae. However, despite initially promising results, a major randomized clinical trial refuted the benefits of MHT, leading to its falling from favor. However, reappraisal of this study in the framework of a "critical window," or "timing hypothesis," has changed our perspective on the benefit-to-risk ratio of MHT, and this review discusses the historical, current, and future approaches to MHT.

Disciplines

Medicine and Health Sciences | Pharmacy and Pharmaceutical Sciences

Keywords

Cardiovascular Diseases, Dementia, Estradiol, Estrogen Replacement Therapy, Female, Humans, Randomized Controlled Trials as Topic

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Peer Reviewed

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