Menopausal hormone therapy in women with medical conditions

Kapoor, Ekta; Kling, Juliana M.; Lobo, Angie S.; Faubion, Stephanie S.

doi:10.1016/j.beem.2021.101578

Cited by 19 publications

(15 citation statements)

References 99 publications

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“…Low-dose transdermal HT is not associated with thrombotic risk in observational studies, and off-label use may be considered in women with significant VMS and a history of VTE if appropriately anticoagulated. 11,40,42,[82][83][84] For women with systemic lupus erythematosus and high disease activity, positive anticardiolipin antibody or positive lupus anticoagulant, oral HT should generally be avoided. On the other hand, HT may be prescribed to women with systemic lupus erythematosus who have mild to moderate disease activity who do not have additional risk factors for VTE.…”

Section: Vte and Pulmonary Embolismmentioning

confidence: 99%

Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long?

et al. 2023

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Menopausal hormone therapy (HT) was widely used in the past, but with the publication of seminal primary and secondary prevention trials that reported an excess cardiovascular risk with combined estrogen-progestin, HT use declined significantly. However, over the past 20 years, much has been learned about the relationship between the timing of HT use with respect to age and time since menopause, HT route of administration, and cardiovascular disease risk. Four leading medical societies recommend HT for the treatment of menopausal women with bothersome menopausal symptoms. In this context, this review, led by the American College of Cardiology Cardiolovascular Disease in Women Committee, along with leading gynecologists, women’s health internists, and endocrinologists, aims to provide guidance on HT use, including the selection of patients and HT formulation with a focus on caring for symptomatic women with cardiovascular disease risk.

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Section: Vte and Pulmonary Embolismmentioning

confidence: 99%

Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long?

et al. 2023

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“…Important risks to counsel patients on when starting HT include the low risk of stroke and venous thromboembolism (VTE) when using oral formulations. 26…”

Section: Additional Ht Benefitsmentioning

confidence: 99%

“…25 When considering formulation of HT, micronized progesterone, dydrogesterone, and drospirenone seem to be most neutral and possibly even beneficial on blood pressure compared with synthetic progestins. 26 Oral estrogen is associated with increased vasoconstriction and/ or increased sodium retention with resultant…”

Section: For Women With Hypertension Prescribe Transdermal Htmentioning

confidence: 99%

“…worsened regulation of blood pressure in women with hypertension, so transdermal estrogen is preferred for women with hypertension. 26 Hypertension is a component of the ASCVD risk score; factoring this into a patient's clinical picture is important when discussing appropriateness of HT prescribing. To minimize risks, the transdermal route of estrogen is preferred for those with hypertension.…”

Section: Nonhormonal Treatments For Menopausal Symptoms Can Include C...mentioning

confidence: 99%

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How should you advise your 54-year-old patient about the use of HT?

Mehta¹

2022

OBGM

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CASE Healthy woman with hot flashes inquires about HTA 54-year-old healthy woman with a history of hypothyroidism taking thyroid replacement medication comes in for her annual visit. Her last menstrual period was over 2 years ago and she reports severe hot flashes. They have greatly affected her quality of life and she must take frequent breaks at work. She wakes up frequently at night due to night sweats, which is impacting her sleep and, subsequently, her energy level. She has noted increased vaginal dryness so has been abstaining from sexual intercourse due to the discomfort. She has an intact uterus. Her family history is significant for heart disease, diagnosed in her mother at age 75.On physical examination, she is normotensive and well-appearing. Her body mass index (BMI) is 21 kg/m 2 . Labs obtained prior to her visit show normal renal and liver function. Her highdensity lipid (HDL) level is 55 mg/dL, her low-den-sity lipid (LDL) level is 80 mg/dL, and her triglyceride level is 100 mg/dL; HbA 1c is 5.5 mmol/mol. She is interested in learning more about menopausal hormone therapy (HT) and whether or not she would be a candidate.

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“…Menopause hormone therapy (MHT), currently available in an ever-expanding array of formulations, routes of administration, and dosages, continues to appear to be the most effective treatment for menopause-related symptoms. However, the decision to implement it may be complex, especially in women with chronic medical conditions, such as diabetes, obesity and autoimmune diseases [ 45 , 46 ]. An attempt to evaluate the effectiveness of MHT in relieving oral symptoms in postmenopausal women with dry mouth was undertaken in a recent study by Wang et al The study was conducted with the help of a questionnaire related to oral dryness and laboratory estimation of salivary estradiol levels in unstimulated saliva before and after case group was subjected to MHT.…”

Section: Saliva Of Menopausal Womenmentioning

confidence: 99%

Changes in the Oral Cavity in Menopausal Women—A Narrative Review

Ciesielska

Kusiak

Ossowska

et al. 2021

IJERPH

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Oral health awareness during the menopausal period is essential to minimize the inevitable inconveniences which may occur due to hormonal changes. The decrease in estrogen hormone concentration impacts the oral mucosa in a similar way to the vaginal mucosa due to the presence of estrogen receptors in both of these structures. An estrogen deficiency also affects the maturation process of the oral mucosal epithelium and can lead to its thinning and atrophy, making it more susceptible to local mechanical injuries, causing a change in pain tolerance and problems in the use of removable prosthetic restorations. Mucosal epithelium during the menopausal period is more vulnerable to infections, candidiasis, burning mouth syndrome, oral lichen planus (OLP), or idiopathic neuropathy. Moreover, salivary glands are also hormone-dependent which leads to changes in saliva secretion and its consistency. In consequence, it may affect teeth and periodontal tissues, resulting in an increased risk of caries and periodontal disease in menopausal women. Due to the large variety of complaints and symptoms occurring in the oral cavity, menopausal women constitute a significant group of patients who should receive special preventive and therapeutic care from doctors and dentists in this particular period.

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Menopausal hormone therapy in women with medical conditions

Cited by 19 publications

References 99 publications

Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long?

Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long?

How should you advise your 54-year-old patient about the use of HT?

Changes in the Oral Cavity in Menopausal Women—A Narrative Review

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