10.1371/journal.pmed.1003731
Menopausal hormone therapy and women's health: an umbrella review. [Dataset]
Zhang, Guo-Qiang
Guo-Qiang
Zhang
Chen, Jin-Liang
Jin-Liang
Chen
Luo, Ying
Ying
Luo
Mathur, Maya B.
Maya B.
Mathur
Anagnostis, Panagiotis
Panagiotis
Anagnostis
Nurmatov, Ulugbek
Ulugbek
Nurmatov
Talibov, Madar
Madar
Talibov
Zhang, Jing
Jing
Zhang
Hawrylowicz, Catherine M.
Catherine M.
Hawrylowicz
Ann Lumsden, Mary
Mary
Ann Lumsden
Critchley, Hilary
Hilary
Critchley
Sheikh, Aziz
Aziz
Sheikh
Lundbäck, Bo
Bo
Lundbäck
Lässer, Cecilia
Cecilia
Lässer
Kankaanranta, Hannu
Hannu
Kankaanranta
Lee, Siew Hwa
Siew Hwa
Lee
Nwaru, Bright I.
Bright I.
Nwaru
Public Library of Science
2021
Estrogen; Menopausal hormone therapy; Meta-analysis; Progestin; Umbrella review
2021-07-12
2021-06-07
Dataset
Why was this study done? By 2050, it is estimated that worldwide more than 1.6 billion women will have reached menopause or be postmenopausal, up from 1 billion in 2020 and up to 75% of menopausal women are affected by bothersome menopausal symptoms, such as hot flashes and night sweats. Menopausal hormone therapy (MHT) is the most effective treatment for alleviating menopausal symptoms, but its effects on numerous health outcomes remain uncertain. What did the researchers do and find? The authors included 60 published systematic reviews of MHT use in menopausal women, involving 102 meta-analyses of randomized controlled trials and 38 of observational studies, and synthesized the evidence on 102 health outcomes. Overall, MHT had a complex balance of benefits and harms; for example, beyond alleviation of menopausal symptoms, it was associated with decreased risks of bone fracture, diabetes mellitus, and esophageal, gastric, and colorectal cancer, but increased risks of stroke, venous thromboembolism, gallbladder disease, and breast and ovarian cancer. The available clinical data in support of MHT reducing the risk of coronary heart disease and all-cause mortality in women aged [more than] 60 years or within 10 years from menopause (known as the “timing hypothesisâ€) were only suggestive. The overall quality of included systematic reviews was moderate to poor. What do these findings mean? This overview of the evidence landscape could help guideline developers and decision-makers better appreciate the trade-offs between the benefits and harms associated with MHT use in menopausal women. More data are needed to evaluate the timing hypothesis for coronary heart disease and all-cause mortality. Clinicians should evaluate the scientific strength of systematic reviews prior to considering applying their results in clinical practice.