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Surgical Menopause

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Oophorectomy, Estrogen, and Dementia: A 2014 Update
Rocca, W.A., Grossardt, B.R., Shuster, L.T., Molecular and Cellular Endocrinology, published online February 10, 2014.

The effects of estrogen on the brain vary with age at the time of treatment. Estrogen naturally produced by the ovaries before age 50 years is neuroprotective. Estrogen treatment (ET) in early menopause may be neuroprotective (most commonly at ages 50–60 years). ET in late menopause (ages 65–79 years) is harmful regardless of the type of menopause. Women who experience premature or early menopause either naturally or after bilateral oophorectomy should receive ET.

Effect of Hormone Replacement Therapy on Cardiovascular Events in Recently Postmenopausal Women: Radomised Trial
Schierbeck, L.L, Rejnmark, L, Tofteng, C.L, et al., BMJ: 345: e6409 (2012).

Conclusion: After 10 years of randomized treatment, women receiving hormone replacement therapy early after menopause had a significantly reduced risk of mortality, heart failure, or myocardial infarction, without any apparent increase in risk of cancer, venous thromboembolism, or stroke.

The 2012 Hormone Therapy Position Statement of The North American Menopause Society
The North American Menopause Society, Menopause: The Journal of the North American Menopause Society 19: 257-271 (2012).

Conclusion: Recent data support the initiation of hormone therapy around the time of menopause to treat menopause-related symptoms and to prevent osteoporosis in women at high risk of fracture. The more favorable benefit-risk ratio for estrogen therapy (ERT) allows more flexibility in extending the duration of use compared to estrogen + progesterone (HRT) where the earlier appearance of increased breast cancer risk precludes a recommendation for use beyond 3 to 5 years.

Premature menopause or early menopause: long-term health consequences
Shustere, LT, Rhodes, D, Gostout, B, Grossardt, B, Rocca, W, Maturitas (European Menopause Journal), 2010 February; 65(2): 161.

Conclusion: Regardless of the cause, women who experience hormonal menopause and estrogen deficiency before reaching the median age of natural menopause are at increased risk for morbidity and mortality. Estrogen treatment should be considered for these women, but may not eliminate all of the adverse outcomes.

Effect of Short-Term Hormone Replacement Therapy on Breast Cancer Risk Reduction After Bilateral Prophylactic Oophorectomy in BRCA1 and BRCA2 Mutation Carriers: The PROSE Study Group
Timothy R. Rebbeck, Tara Friebel, Theresa Wagner, Henry T. Lynch, Judy E. Garber, Mary B. Daly, Claudine Isaacs, Olufunmilayo I. Olopade, Susan L. Neuhausen, Laura van 't Veer, Rosalind Eeles , D. Gareth Evans, Gail Tomlinson, Ellen Matloff, Steven A. Narod, Andrea Eisen, Susan Domchek, Katrina Armstrong, and Barbara L. Weber. Journal of Clinical Oncology, (Published on-line ahead of print).,October 2005.

Safety and Efficacy of a Testosterone Patch for the Treatment of Hypoactive Sexual Desire Disorder in Surgically Menopausal Women
Glenn D. Braunstein, Dale A. Sundwall, Molly Katz, Jan L. Shifren, John E. Buster, James A. Simon, Gloria Bachman, Oscar A. Aguirre, Johna D. Lucas, Cynthia Rodenberg, Akshay Buch, Nelson B. Watts. Archives of Internal Medicine, Volume 165 Number 14: p. 1582-1589, July 2005.

Effect of Zolpidem on sleep in women with perimenopausal and postmenopausal insomnia: a 4-week, randomized, multicenter, double-blind, placebo-controlled study
Cynthia M. Dorsey, Kathryn A. Lee, Martin B. Scharf. Clinical Therapeutics, Volume 26, Issue 10: p. 1578-1586, October 2004.

BRCA germline mutations in Jewish women with uterine serous papillary carcinoma
Ofer Lavie, Gila Hornreich, Alon Ben-Arie, Gad Rennert, Yoram Cohen, Rehuven Keidar, Shlomi Sagi, Efrat Levy Lahad, Ron Auslander, Uzi Beller. Gynecologic Oncology, Volume 92, Number 2: p. 521-524, February 2004.

Phase III Evaluation of Fluoxetine for Treatment of Hot Flashes
Charles L. Loprinzi, Jeff A. Sloan, Edith A. Perez, Susan K. Quella, Phillip J. Stella, James A. Mailliard, Michele Y. Halyard, Sandhya Pruthi, Paul J. Novotny, Teresa A. Rummans. Journal of Clinical Oncology, Volume 20, Issue 6: p. 1578-1583, March 2002.

Natural Hormone Replacement Therapy: What It Is and What Consumers Really Want
Dana Reed-Kane, PharmD, FIACP, FACA. International Journal of Pharmaceutical Compounding, Volume 5, Number 5: p. 332-335, September/October 2001.

Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations: a case-control study
Steven A Narod, Ping Sun, Parviz Ghadirian, Henry Lynch, Claudine Isaacs, Judy Garber, Barbara Weber, Beth Karlan, David Fishman, Barry Rosen, Nadine Tung, Susan L Neuhausen. Lancet, Volume 12, Issue 357(9267): p. 1467-70, May 2001.

BRCA1/2 Mutation Carriers are Potentially at Higher Cardiovascular Risk
Arts-de Jong, M.A, Maas, A.H.E.M. , Massuger, L.F., et al., Critical Reviews in Oncology Hematology , published online February 18, 2014.

Conclusion: Further clinical and translational research is needed to determine CVD risk in BRCA1/2 mutation carriers concentrating on both classical CVD risk factors as well as the risk factors specific for BRCA1/2 mutation carriers. Until more evidence on CVD risk in BRCA1/2 mutation carriers is provided, caregivers should pay additional attention on their traditional CVD risk factors. In addition, HRT should be recommended after early surgical menopause to BRCA1/2 mutation carriers without a history of breast cancer. This review endorses the compelling need for intensified collaboration between cardiologists, oncologists, gynecologists, and general practitioners to optimize long-term survival in this unique cohort of both young cancer previvors and cancer survivors.

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