Body-identical hormone replacement

Body-identical hormone replacement

Abstract

CLIMACTERIC 2012;15(Suppl 1):1–2 Editorial Body-identical hormone replacement Nick Panay Queen Charlotte’s & Chelsea and Chelsea & Westminster Hospital, Imperial College, London, UK The adverse outcomes seen in the Women’s Health Initiative (WHI)1 were mainly due to an over-dosage of hormones in a relatively elderly population. However, fundamental differences exist between conjugated equine estrogens and 17β-estradiol and between medroxyprogesterone acetate and natural progesterone. It is likely that these differences also contributed to the adverse outcomes in the WHI, which were contrary to the cardiovascular benefits seen in previous observational trials. Recent studies of cardiovascular risk markers in younger women have been designed using predominantly estradiol and natural progesterone (transdermal and oral) as the primary interventions2,3. This Editorial accompanies four manuscripts in which the authors explore, through review of the literature and presentation of their own data, the effects that estradiol and progesterone can have, both in the physiological environment and also when replaced as transdermal estradiol and micronized oral progesterone. effects of oral conjugated equine estrogens are complex and have still not been fully evaluated. However, there are some fundamental differences between oral and transdermally administered estradiol due to the avoidance of first-pass hepatic metabolism. In theory, this manifests