Menopausal Hormone Therapy and Mortality: A Systematic Review and Meta-Analysis

Program: Abstracts - Orals, Poster Previews, and Posters
Session: FRI 102-126-Hyperandrogenic Disorders and Menopause
Basic/Clinical
Friday, March 6, 2015: 1:00 PM-3:00 PM
Hall D-F, Reproductive Endocrinology (San Diego Convention Center)

Poster Board FRI-125
Khalid Benkhadra, MD, Khaled Mohammed, MBBCh, Alaa Al Nofal, MD, Barbara Gisella Carranza Leon, MD, Fares Alahdab, Abd Moain Abu Dabrh, MBBCh, MS, Jorge Zuniga, MD and Mohammad Murad
Mayo Clinic, Rochester, MN
Objectives: To assess all-cause and cause specific mortality (myocardial infarction, stroke and cancer) associated with Menopausal hormone therapy (MHT) in postmenopausal women.

Methods: A comprehensive search of several online databases from each database’s earliest inception to August 2013. The databases included Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Randomized trials of follow up ≥ 6 month were included if they compared MHT with placebo or no treatment and reported an effect size for outcomes.

Results: Meta-analysis from 43 randomized controlled trials showed no association between all cause-mortality was and MHT [risk ratio (RR) 0.99 (95% confidence interval 0.94-1.05)] with no significant interaction based on hormone type or pre-existing heart disease. No association was found between MHT use and mortality due to myocardial infarction (RR 1.04, 95%CI 0.87-1.23), breast cancer (RR 0.93, 95%CI 0.26-3.32) or stroke (RR 1.49, 95%CI 0.95-2.31). Postmenopausal women taking MHT with cancer other than breast cancer had increased cancer mortality (RR 1.34 95%CI 1.09-1.67) compared to placebo   

Conclusion: Moderate to high quality evidence from randomized controlled trials suggests that MHT use is not associated with a significant effect on all-cause mortality, cardiovascular death or breast cancer death; but may increase the risk of other types of cancer death. 

Nothing to Disclose: KB, KM, AA, BGC, FA, AMA, JZ, MM

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