Exam 2 - Women's health initiative

Question 1

Why was hormone therapy given prophylactically in the past?

Answer 1

Thought could prevent menopausal symptoms and cardio-protective

• Since disproven - HT not prescribed for chronic disease prevention in postmenopausal women

Question 2

What were the general findings of the WHI studies?

Answer 2

EPT more harmful than beneficial

• Estrogen and progesterone therapy associated with increased risk of breast cancer and CVD (why we d/c after 5 years)

Question 3

WHI findings of hormone therapy by age: age 50-59 years

Answer 3

• Higher risk of VTE
• Starting estrogen before menopause decreases risk of breast cancer (NOT EPT group)
  
  • Starting estrogen 2 years after menopause increases risk

Question 4

WHI findings of hormone therapy by age: age 60-69 years

Answer 4

• Lower rate of breast cancer and CVD
• HT no effect on mortality rates

Question 5

WHI findings of hormone therapy by age: 70-79 years

Answer 5

• Overall outcomes worse compared with control, but rate of breast cancer not much higher
• HT showed slight increase in mortality

Question 6

Between estrogen and progesterone, which is proliferative? Anti-proliferative?

Answer 6

Estrogen - proliferative

Progesterone - anti-proliferative

Question 7

Can HT increase risk for CAD when initiated later in life?

Answer 7

Yes

• Estrogen antioxidant properties can destabilize existing plaque - increased risk for CVD and stroke in older women

Question 8

Which is preferred, ET or EPT, to relieve symptoms in older perimenopausal and younger postmenopausal women?

Answer 8

Estrogen therapy

• EPT associated with higher risk of breast cancer