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A Perspective on HRT for Women: Picking Up the Pieces After the Women's Health Initiative Trial - Part 1

Author(s):  Gillson George R, Zava David T

Issue:  Jul/Aug 2003 - After the Women's Health Initiative Trial
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Abstract:  This article is the first of a two-part series discussing hormone replacement therapy. These articles discuss important concepts about the less-than-optimal results achieved so far with conventional hormone replacement therapy, consider the possibility that some types of hormone replacement therapy are safer than others and discuss reasons why they are safer. They are intended to supply clinicians with additional information as a basis for decisions about bioidentical estrogen and progesterone replacement now that the standard of care is in question. Specifically, Part 1 focuses on differences between bioidentical and conventional hormone replacement therapy (fundamental principles, compliance, estrogens [composition of metabolites, oral estrogen replacement therapy and transdermal estrogen] and estriol [composition of metabolites, bioavailability of metabolites, oral estriol, vaginal estriol and bioaccumulation]). The authors conclude that, although controlled trials have not been conducted with Tri-Est and Bi-Est (oral form or skin cream), these may be less likely to cause harm over the long term. Each practitioner must consider the evidence about whether to prescribe bioidentical or conventional hormone replacement therapy and weigh the benefits against possible risks, since there is no longer any clear standard of care.

Related Keywords: Bioidentical hormone replacement therapy, Estriol, in hormone replacement therapy, Estrogen, oral, in hormone replacement therapy, Estrogen, transdermal, in hormone replacement therapy, Hormone replacement therapy, bioidentical, Hormone replacement therapy, conventional

Related Categories: HRT

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