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  • Underuse of estrogen...

Underuse of estrogen therapy in premenopausal women undergoing oophorectomy associated with high morbidity and mortality: Study

Written By : Dr. Shravani Dali By : Dr. Kamal Kant Kohli Published On 2024-07-05T21:00:52+05:30  |  Updated On 6 July 2024 10:46 AM IST
Underuse of estrogen therapy in premenopausal women undergoing oophorectomy  associated with high morbidity and mortality: Study
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Underuse of estrogen therapy in premenopausal women undergoing oophorectomy is associated with high morbidity and mortality suggests a study published in the American Journal of Obstetrics & Gynecology.

Contrary to clinical guidelines, there has been a decrease over time in estrogen therapy use in premenopausal women undergoing bilateral oophorectomy for benign indications. This study aimed to estimate the excess morbidity and mortality associated with current patterns of estrogen therapy use in women who undergo bilateral oophorectomy with hysterectomy for benign indications.They developed 2 Bayesian sampling Markov state-transition models to estimate the excess disease incidence (incidence model) and mortality (mortality model). The starting cohort for both models were women who had undergone bilateral oophorectomy with hysterectomy for benign indications at the age of 45 to 49 years. The models tracked outcomes in 5-year intervals for 25 years.

The incidence model estimated excess incidence of breast cancer, lung cancer, colorectal cancer, coronary heart disease, and stroke, whereas the mortality model estimated excess mortality due to breast cancer, lung cancer, coronary heart disease, and all-other-cause mortality. The models compared current rates of estrogen therapy use with optimal (100%) use and calculated the mean difference in each simulated outcome to determine excess disease incidence and death. Results: By 25 years after bilateral oophorectomy with hysterectomy, there were an estimated 94 (95% confidence interval, −158 to −23) fewer colorectal cancer cases, 658 (95% confidence interval, 339–1025) more coronary heart disease cases, and 881 (95% confidence interval, 402–1483) more stroke cases. By 25 years after bilateral oophorectomy with hysterectomy, there were an estimated 189 (95% confidence interval, 59–387) more breast cancer deaths, 380 (95% confidence interval, 114–792) more coronary heart disease deaths, and 759 (95% confidence interval, 307–1527) more all-other-cause deaths. In sensitivity analyses where we defined estrogen therapy use as a duration of >2 years of use, these differences increased >2-fold. Underuse of estrogen therapy in premenopausal women who undergo oophorectomy is associated with substantial excess morbidity and mortality.

Reference:

Ferris JS, Suzuki Y, Prest MT, Chen L, Elkin EB, Hur C, Hershman DL, Wright JD. Excess morbidity and mortality associated with underuse of estrogen replacement therapy in premenopausal women who undergo surgical menopause. Am J Obstet Gynecol. 2024 Jun;230(6):653.e1-653.e17. doi: 10.1016/j.ajog.2024.02.007. Epub 2024 Feb 15. PMID: 38365100.

Underuseestrogentherapypremenopausalwomenundergoingoophorectomyhigh morbiditymortalitystudy
Source : American Journal of Obstetrics & Gynecology
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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