Estrogen use and postmenopausal women: a basis for informed decisions. NIH Consensus Development.

ABSTRACT

PIP: This National Institutes of Health consensus report of a panel of experts summarizes the currently available information on postmenopausal estrogen use, as presented by the invited speakers, panelists, and members of the audience, and each section published here represents an excerpt of the consensus statement followed by commentary. Reference to 3 background papers, which are published and available, is made for presentation of more detailed discussion. The following consensus was reached concerning estrogen use and postmenopausal women: 1) the use of estrogens alleviates vasomotor symptoms and atrophy of vaginal epithelium and may aid in preventing osteoporosis. The possibility of increased incidence of endometrial cancer with estrogen use is also acknowledged. Combinations of progestin and estrogen may alleviate this increased risk, but potential risks of progestin have not been studied adequately in postmenopausal women with no ovarian function. 2) there is no convincing evidence that postmenopausal estrogen use influences occurrence of cardiovascular disease and breast cancer. Also agreed upon is the patient management of a potential estrogen replacement therapy candidate: she should be given as much information as possible about both benefits and risks and with her physician's help, she should reach an individualized decision about estrogen use.