The discordant findings from observational studies and randomized clinical trials affect doctors' decisions concerning hormonetherapy for menopausal women. BCSM
Information from prospective studies on the effects of commencing MHT at various ages between 40 and 59 years show that for women who commenced treatment at any time within this age range, the relative risk was similar and was highly significant for all ages. Few women had started MHT treatment well after menopause at ages 60 to 69 years, and their excess risks during years 5 to 14 of current use were significant for estrogen-progestogen, but not for estrogen-only MHT.
During 5 to 14 years of MHT use, the RRs were similarly increased if MHT use had started at ages 40 to 44 years, 45 to 49 years, 50 to 54 years, and 55 to 59 years; RRs appeared to be attenuated if MHT use had started after age 60 years. They were also attenuated by adiposity, particularly for estrogen-only MHT . After MHT use ceased, some excess risk of breast cancer persisted for more than a decade; this is directly correlated with the duration of treatment.
Therefore, it can be expected that the effects of MHT may vary between participants on the basis of age or time since menopause, as well as treatments . Regarding formulation effects on the risk of breast cancer, new evidence shows an increased risk of 28%. Progestogens appeared to be differentially associated with breast cancer . When prescribing MHT,In conclusion, MHT has a complex balance of benefits and risk on various health outcomes. Some effects differ qualitatively between ET and EPT.
status, and prior hysterectomy and that some outcomes persist and that there is some attenuation after stopping use.
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