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Hormone replacement therapy following myocardial infarction, stroke and venous thromboembolism
Published in Barry G. Wren, Progress in the Management of the Menopause, 2020
Recently published large-scale epidemiological studies confirmed that prolonged hormone replacement therapy reduces the risk for future cardiovascular events by 30–50%1,2. Other clinical studies demonstrated that hormone users had a better cardiovascular risk profile when compared with that of non-users or of women receiving placebo3–5. According to Grady and colleagues the lifetime probability for coronary artery disease in a 50-year-old white woman treated with long-term hormone replacement is 12% lower than that in non-users6. pressure was not influenced by postmenopausal hormonal treatment.
Introduction
Published in Myra Hunter, Melanie Smith, Managing Hot Flushes and Night Sweats, 2020
This new edition of our book provides an up-to-date guide to managing menopausal symptoms that can impact on quality of life, especially at work where women often find that they are more challenging to deal with (Griffiths and Hunter 2015). This self-help guide is for women who are seeking a non-medical treatment, or an alternative to hormone replacement therapy (HRT), for troublesome hot flushes and night sweats. It is also written for women who are experiencing these symptoms following breast or gynaecological cancer treatment, for working women, for women who are going through an early menopause and also for health professionals working with women who have menopausal symptoms. The book is based on cognitive behavioural therapy (CBT), which provides information and practical ways to change beliefs and attitudes and to develop helpful ways to deal with hot flushes and night sweats. We hope that it will be useful if you are having problematic symptoms but also if you just want to be better informed.
Breast cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
The majority of cases are sporadic, and only 5% cases are due to a known genetic mutation. Hormonal influences are well recognized; breast cancer is more common in women with an early menarche or a late menopause. The use of combined oral contraceptive pill for around 10 years is associated with an relative risk of around 1.25 after its cessation. Hormone replacement therapy (HRT) is also associated with an increased risk of breast cancer (14 in 1000 women aged 50–64 not taking HRT develop breast cancer over 5 years, compared to 15.5 in 1000 taking oestrogen-only HRT for 5 years and 20 in 1000 for those taking combined [oestrogen/progestogen] HRT for 5 years).
Non-typhoidal Salmonella soft-tissue infection after gender affirming subcutaneous mastectomy case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2023
Branden T. Barger, Mikhail Pakvasa, Melinda Lem, Aishu Ramamurthi, Shadi Lalezari, Cathy Tang
In addition, acne [27] and weight gain [28] are well-documented and common side effects from masculinizing hormone replacement therapy. Though previous literature reports that the most common skin contaminants of acne are Propionibacterium and Cuitbacterium species, other native skin flora and bacterial species such as Staphylococcus aureus, Streptococcus pyrogenes, and Corynecterium species, have been documented [29]. Staphylococcus aureus is also known to be the most common bacterial species in patients with seborrheic dermatitis [30]. Our patient did not undergo pre-operative skin flora culturing, however, it is possible that the microbiologic findings from his SSI wounds, including MRSA, Pseudomonas, and Salmonella, may have been contributors to his dermatologic concerns prior to surgery as well as later complicated proper surgical wound healing. Prior research has indicated that acne treatment such as benzoyl peroxide prior to surgery can lower rates of SSI [31,32], however specific research is needed to better elucidate how HRT-associated acnes, native skin flora, and bacterial overgrowth may impact successful wound healing following chest masculinization and other gender affirming procedures.
Association of climacterium with temporomandibular disorders at the age of 46 years – a cross-sectional study
Published in Acta Odontologica Scandinavica, 2023
Eerika Mursu, Jia Yu, Elina Karjalainen, Susanna Savukoski, Maarit Niinimäki, Ritva Näpänkangas, Paula Pesonen, Pertti Pirttiniemi, Aune Raustia
Climacterium, the time of gradual loss of oestrogen production and ovarian function (ovulation and oestrogen production), naturally appears in women in their 50 s [12]. The mean natural age of menopause (last menstruation) is 51 years, but 5–10% of women experience menopause at age 40–44 (early menopause, EM) and about 1% by the age of 40 (premature ovarian insufficiency, POI) [13]. When the ovarian function decreases during the climacterium, the pituitary gland attempts to raise the circulating oestrogen levels by secreting more follicle-stimulating hormone (FSH) which stimulates the ovaries throughout the menstrual cycle to produce oestrogen [14]. The circulating FSH is shown to be associated with serum oestradiol (E2) [15]. During climacterium, the menstrual cycle will gradually cease, from irregular cycles to amenorrhoea, and decreased oestrogen levels cause subjective symptoms, namely hot flushes, sweating, sleep disturbance, and altered mood. Hormone replacement therapy (HRT) with oestrogen has been shown to be effective to alleviate menopausal symptoms [16]. At the time of menopause, more than half of women also report musculoskeletal pain and pain in the joints, but the evidence is still lacking concerning the association between sex hormones and musculoskeletal pain [17].
The effects of hormone replacement therapy on the microbiomes of postmenopausal women
Published in Climacteric, 2023
M. I. Dothard, S. M. Allard, J. A. Gilbert
As loss of estrogen synthesis and circulation is the chief cause underlying postmenopausal symptoms, a treatment option often prescribed to postmenopausal women is intaking a regulated amount of exogenous estradiol [52,53]. This is called hormone replacement therapy (HRT) or menopausal hormone therapy. HRT is an umbrella term used to describe two different treatments for postmenopausal women. Unopposed estrogen, or estrogen treatment alone, is prescribed to postmenopausal women who have undergone hysterectomy [52]. To reduce the risk of proliferative diseases like cancers of the breast and/or endometrium, a combination of estrogen and progestin is administered to postmenopausal women with intact uteri. HRT can be taken orally, transdermally, through the use of topical gels, local lotions and creams or via vaginal rings [53]. HRT is taken systemically in order to treat hot flashes, and local low-dose estrogen in order to treat genitourinary symptoms like vaginal atrophy [53]. Women who are prescribed HRT are usually given 17β-estradiol either orally or transdermally, to be taken daily [53]. Oral HRT is not prescribed to women with pre-existing conditions like hypertriglyceridemia, active gallbladder disease or known thrombophilias [53,54]. Low doses of estradiol or estradiol and progestin are prescribed to postmenopausal women and dosage is then modulated until desired effects are seen [53,54]. For women with intact uteri, progestin can be taken daily or in a 12-day/month cycle intended to recapitulate the luteal phase of premenopausal women [53,54].