Effects of hormone-replacement therapy on hemostatic factors, lipid factors, and endothelial function in women undergoing surgical menopause: Implications for prevention of atherosclerosis☆,☆☆,★,★★
Section snippets
Methods
We conducted a prospective study to investigate the effect of introducing estrogen-only HRT (oral conjugated estrogens as Premarin, 0.625 mg) in consecutive women undergoing (premature) surgical menopause after hysterectomy and bilateral oophrectomy during a 6-month period. Women were generally undergoing the surgery for previous dysfunctional uterine bleeding. Patients were studied before the hysterectomy (visit 1), 6 weeks after the hysterectomy (visit 2, at which time HRT was started), and
Results
We studied 27 premenopausal women (mean age 43.6 ± 6.5 years) undergoing hysterectomy and bilateral salpingo-oophrectomy, who consented to participate in this study. All the patients had menopausal symptoms by 6 weeks after surgical menopause, which was followed by (reported) symptomatic relief from these symptoms after the introduction of HRT.
Plasma levels of follicle-stimulating hormone and luteinizing hormone were normal before hysterectomy, with elevations in plasma follicle-stimulating
Discussion
This study is limited by the small sample size and short follow-up periods (6 weeks) after surgical menopause and the introduction of HRT. Thus changes in the various markers that were measured might have been more impressive if there had been longer follow-up periods while the patients were menopausal (i.e., after hysterectomy but before HRT) and after the introduction of HRT. However, because many women in the study had symptoms, there remains an ethical consideration if HRT were withheld for
Acknowledgements
We thank Dr. John Zarifis and Michèle Beevers, SRN, for assistance with data collection and Dr. P. Davies for valuable statistical advice.
References (42)
- et al.
The status of PAI-1 as a risk factor for arterial and thrombotic disease: a review
Atherosclerosis
(1992) - et al.
Plasma P-selectin is increased in thrombotic consumptive platelet disorders
Blood
(1994) - et al.
Hemostatic factors according to menopausal status and use of hormone replacement therapy
Ann Epidemiol
(1992) - et al.
Reversal of acetylcholine effect on atherosclerotic coronary arteries by estrogen: pharmacologic phenomenon of clinical importance?
J Am Coll Cardiol
(1992) - et al.
Effect of estradiol-17β on blood flow to reproductive and non-reproductive tissues in pregnant ewes
Am J Obstet Gynecol
(1976) - et al.
The effects of hormone replacement therapy in normal postmenopausal women: measurements of Doppler-derived parameters of aortic flow
Am J Obstet Gynecol
(1991) - et al.
Beneficial effect of oestrogen on exercise-induced myocardial ischaemia in women with coronary artery disease
Lancet
(1993) - et al.
Concurrent risk factors
- et al.
Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature
Ann Intern Med
(1993) - et al.
Fibrin D-dimer: a useful clinical marker of thrombogenesis?
Clin Sci
(1995)
Lipoprotein (a) and vascular disease: thrombogenesis and atherogenesis
Q J Med
A reliable marker of endothelial cell dysfunction: does it exist?
Br J Haematol
von Willebrand factor and its relevance to cardiovascular disease
Br Heart J
von Willebrand factor, soluble P-selectin, tissue plasminogen activator and plasminogen activator inhibitor in atherosclerosis
Thromb Haemost
Working party on blood pressure measurement videotape “blood pressure measurement.”
BMJ
Thrombomodulin
Semin Thromb Haemost
Effect of continuous combined estrogen and desogestrel hormone replacement therapy on serum lipids and lipoproteins
Obstet Gynecol
Association of hormone replacement therapy with various cardiovascular risk factors in postmenopausal women, the Atherosclerosis Risk in Communities Study Investigators
N Engl J Med
Effects of hormone replacement therapy on lipoprotein (a) and lipids in postmenopausal women
Arterioscler Thromb
The lowering of lipoprotein (a) induced by estrogen plus progesterone replacement therapy in postmenopausal women
Arch Intern Med
Effects of age, sex and menopausal status on plasma lipoprotein (a) levels: the Framingham Offspring study
Circulation
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2022, Reproductive BioMedicine OnlineCitation Excerpt :Most studies that were about normal menopause or did not evaluate the effects of hormone therapy were excluded at the screening phase. Among the 28 articles excluded through full text reading, 13 were excluded because the study participants were on average older than 40 years at baseline (Baksu et al., 2007; Basbug et al., 1997; Bhattacharya and Jha, 2010; Castelo-Branco et al., 1993; Eeles et al., 1991; Haines et al., 1995; Kilic et al., 2010; Lip et al., 1997; Lyritis et al., 1995; Madalinska et al., 2006; Sherwin and Gelfand, 1985a,b; Somunkiran et al., 2007), and seven because the study interventions (Bakhsh et al., 2015; Christ et al., 2018; Honigberg et al., 2019; Wong et al., 2018) or outcomes (Elkind-Hirsch et al., 1992, 1993; Kapetanakis et al., 1982) were not compatible with the review entry criteria (Figure 1). Five studies were also excluded that evaluated hormone therapy in women with POI but had a cross-sectional design (Bachelot et al., 2016; Benetti-Pinto et al., 2019; Cardona Attard et al., 2019; Giraldo et al., 2017; Kurabayashi et al., 1993), one study protocol (Mittal et al., 2013), one possible overlap with another report (Li et al., 1991) and a review (Atsma et al., 2006).
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Supported by Dr. J. Amiral (Serbio, Gennevilliers, France).
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aRecipient of the 1994 Edith Walsh and Ivy Powell Research Awards and the 1995 Nathaniel Bishop Harman Award for Cardiovascular Disease Research from the British Medical Association.
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Reprint requests: G. Y. H. Lip, MD, Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, England.
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