Conjugated estrogens for the treatment of menopausal symptoms: a review of safety data

@article{Mirkin2014ConjugatedEF,
  title={Conjugated estrogens for the treatment of menopausal symptoms: a review of safety data},
  author={Sebasti{\'a}n Mirkin and Barry S. Komm and James H. Pickar},
  journal={Expert Opinion on Drug Safety},
  year={2014},
  volume={13},
  pages={45 - 56}
}
Introduction: Conjugated equine estrogens (CEE) are widely used for the treatment of menopausal symptoms, such as vasomotor symptoms and vulvovaginal atrophy, and for the prevention of bone loss, in postmenopausal women. The safety profile of CEE has been extensively published over the past 20 years. Areas covered: Data from randomized controlled trials and from observational studies on the effects of CEE on the risk of breast cancer, endometrial cancer or hyperplasia, other cancers… Expand
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Effect of lower doses of conjugated equine estrogens with and without medroxyprogesterone acetate on bone in early postmenopausal women.
TLDR
Lower-than-commonly-prescribed doses of conjugated equine estrogens with medroxyprogesterone acetate with CEEs-MPA improve vasomotor symptoms and vaginal atrophy, provide acceptable bleeding and lipid profiles, and afford endometrial protection in postmenopausal women. Expand
Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial.
TLDR
The use of conjugated equine estrogen (CEE) increases the risk of stroke, decreases therisk of hip fracture, and does not affect CHD incidence in postmenopausal women with prior hysterectomy over an average of 6.8 years, indicating no overall benefit. Expand
Effects of conjugated equine estrogens on cognition and affect in postmenopausal women with prior hysterectomy.
TLDR
CEE does not appear to have enduring effects on rates of domain-specific cognitive change in older postmenopausal women, and was associated with lower spatial rotational performance after an average of 3 yr of treatment. Expand
Effects of conjugated equine estrogens on breast cancer and mammography screening in postmenopausal women with hysterectomy.
TLDR
Treatment with CEE alone for 7.1 years does not increase breast cancer incidence in postmenopausal women with prior hysterectomy, however, treatmentWith CEE increases the frequency of mammography screening requiring short interval follow-up, and initiation of CEE should be based on consideration of the individual woman's potential risks and benefits. Expand
Conjugated equine estrogens and breast cancer risk in the Women's Health Initiative clinical trial and observational study.
TLDR
For women who begin use soon after menopause, combined analyses of clinical trial and observational study data do not provide clear evidence of either an overall reduction or an increase in breast cancer risk with CEEs, although hazard ratios appeared to be relatively higher among women having certain breast cancerrisk factors or a low body mass index. Expand
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TLDR
Two years of treatment with lower doses of CEE/MPA provided endometrial protection comparable to that seen with commonly prescribed doses, and these regimens should be considered for postmenopausal women who are candidates for hormone therapy. Expand
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TLDR
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TLDR
Conjugated equine estrogens provided no overall protection against myocardial infarction or coronary death in generally healthy postmenopausal women during a 7-year period of use. Expand
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