Endocrine Abstracts

During the past decade, few topics in medicine have been more controversial or clinically relevant than the effects of hormone replacement therapy (HRT) on risk for cardiovascular disease (CVD) in postmenopausal women. Based on extensive observational, animal model, and in vitro studies, many clinicians and patients were convinced that HRT lowered risk for CVD, a perception that helped make HRT use one of the most well-established treatment paradigms in American medicine. Howe...

The effect of Oestrogen on brain aging. Declan GM Murphy.The biological basis of human brain aging is poorly understood and there are few proven treatments for age-related brain disease. Recently, however, it has been suggested that HRT may have a 'neuroprotective' effect. Some studies report no beneficial effect of HRT on cognitive function in healthy older women though most show a significant benefit to memory and/or a general cognitive enhancement. There is perhaps grea...

With the recent publication of the results of randomised controlled trials (RCTs) of HRT we are at last developing the potential to assess the relative safety as well as the relative efficacy of preventative treatment. As detailed on the website of the Medicines Control Agency (www.mca.gov.uk), treatment with HRT is associated with an increased risk of cancer of the breast and ovary, of stroke and venous thromboembolism, together with an increased rate of surgery for gallstone...

Oestrogen replacement therapy remains one of the two licensed indications for the use of HRT. The rationale is sound. Oestrogen is from the time of puberty a major regulator of the resorption/formation balance and of the rate of recruitment of BMUs. Natural or surgical withdrawal of oestrogen results in acceleration of turnover, bone loss and potential osteoporosis. Similarly, in the postmenopause, restoration of oestrogen to premenopausal levels restrains turnover, inhibits r...