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The issue of cardiovascular and cognitive health in women is complex. During the premenopausal phase of life women have healthy blood pressure (BP) levels that are lower than age-matched men and they have less cardiovascular disease. However, in the post-menopausal stage of life women's BP increases and they are increasingly susceptible to cardiovascular disease, cognitive impairments and dementia, exceeding the incidence in men. The major difference between pre- and post-menopausal women is the loss of estrogen. Thus, it seemed logical that post-menopausal estrogen replacement therapy, with or without a progestin, generally referred to as menopausal hormone treatment (MHT), would prevent these adverse sequelae. However, despite initially promising results, a major randomized clinical trial refuted the benefits of MHT leading to it falling from favor. However, reappraisal of this study in the framework of a "Critical Window", or "Timing Hypothesis" has changed our perspective on the benefit to risk ratio of MHT and this review discusses the historical, current and future approaches to MHT.
This article was published in the following journal.
Name: American journal of physiology. Heart and circulatory physiology
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The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, DYSPAREUNIA, and progressive development of OSTEOPOROSIS. This may also include the use of progestational agents in combination therapy.
Therapeutic replacement or supplementation of defective or missing enzymes to alleviate the effects of the enzyme deficiency (e.g., GLUCOSYLCERAMIDASE replacement for GAUCHER DISEASE).
The 3-cyclopentyl ether of ETHINYL ESTRADIOL. After gastrointestinal absorption, it is stored in ADIPOSE TISSUE, slowly released, and metabolized principally to the parent compound. It has been used in ESTROGEN REPLACEMENT THERAPY. (From AMA Drug Evaluations Annual, 1992, p1011)
One of the ESTROGEN RECEPTORS that has marked affinity for ESTRADIOL. Its expression and function differs from, and in some ways opposes, ESTROGEN RECEPTOR BETA.
A second generation selective estrogen receptor modulator (SERM) used to prevent osteoporosis in postmenopausal women. It has estrogen agonist effects on bone and cholesterol metabolism but behaves as a complete estrogen antagonist on mammary gland and uterine tissue.
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