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• W1983192206 abstract "In the early 1990s, it was suggested that hormone replacement therapy (HRT) after menopause could play a role in the reduction of coronary heart disease [1-3], in addition to the reduction of the risk of osteoporosis. New information about the effect of HRT emerged after the publication of the Women's Health Initiative (WHI) clinical trial and observational study. More recently, studies by Hoibraaten et al. [4, 5], in addition to the WHI randomized placebo-controlled trial (daily use of 0.625 mg of conjugated equine estrogen and 2.5 mg of medroxyprogesterone acetate [7]), have shown that HRT is associated with an increased risk for arterial and venous (a first episode or a recurrent one) thromboembolism (VTE), although the magnitude is modest. However, many studies during the last years were focused on arterial risk/benefit of HRT, with few studies on the VTE HRT-related risk. This is the reason why studies like ESTHER [8] are welcome in the international scientific scenario. In the paper published in this issue of the Journal, Simon et al. [6] investigated whether or not lifetime endogenous estrogen exposure, as estimated by age at menopause and parity, could be associated with the risk of VTE in women included in the ESTHER study. They found that VTE risk increases 2.6-fold in women with late menopause and about twofold in those with more than two children. The lowest risk of VTE was observed in women with less than two children and in whom menopause occurred at the age below 45. Then, women with late menopause and three or more children have a higher risk of VTE. The authors conclude that the longer exposure to endogenous estrogen is associated with an increased VTE risk. The authors also found a twofold higher risk for the presence of only one risk factor (late menopause/two or more children), the contemporary presence of both being associated with a threefold increased risk. So, we are dealing with a modest risk factor in term of magnitude. This original observation paves the way to similar studies, in order to confirm and extend these data. In addition to the confirmation of these data, it would be interesting to investigate whether or not the risk is higher only because a woman becomes pregnant, independently of pregnancy outcome. In this respect, it would be useful to collect the history of pregnancy losses or pregnancies complicated by pre-eclampsia or other obstetric complications. This would help explore the possibility of a link between VTE and obstetric complications. We still do not know whether or not a woman with a previous VTE has a higher risk of obstetric complications and vice versa. Moreover, studies like this could prompt us to investigate the relationship between VTE and adverse events of pregnancy. It would be interesting to know that what role is played by the acquired and inherited thrombophilia in this setting of patients. The knowledge of a role for acquired and inherited thrombophilia in the occurrence of these type of idiopathic events could help physicians to better define the profile of risk of each woman after menopause." @default.
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• W1983192206 date "2006-01-01" @default.
• W1983192206 modified "2023-10-16" @default.
• W1983192206 title "New epidemiological risk factors for venous thromboembolism (VTE) after menopause" @default.
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• W1983192206 doi "https://doi.org/10.1111/j.1538-7836.2005.01756.x" @default.
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