Safety issues in hormonal therapy

摘要

Safety issues in hormonal therapy have been discussed in recent years especially in the field of hormone replacement therapy(HRT).The most important study Women's Health Initiative(WHI) has been stopped in 2002 due to increased risk of venous thromboembolism,myocardial infarction,stroke and breast cancer.This overview will concentrate on these main risks.There are options of different HRT regimens to minimize these risks.Especially plausible is the use of minimal dosages of transdermal administration avoiding first liver passage which should reduce hepatic and cardiovascular risks,which,however,is not based on placebo-controlled studies.For breast cancer development,first fear of most women,further research on the two main mechanisms are most important-proliferation effects and conditions for potential genotoxic estrogen metabolites.To individualize hormonal therapy also preexisting risks have to be considered,and with early start,within a "window of opportunity",most patients will benefit from HRT if indicated.