Talk:Hormone replacement therapy/Archive 1

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Does this passage really belong to this article ?

HRT is also used by transsexuals to aid them in attaining the secondary sex characteristics of their desired gender.

For male-to-female transsexuals, HRT includes antiandrogens in addition to the estrogens and progestagens mentioned above. For female-to-male transsexuals, HRT consists only of androgens.

someone wrote the above Q, and I think I might agree. Shouldn't such info be at hormone therapy? Martin 17:17 4 Jun 2003 (UTC)

Actually, hormone therapy specifically refers to the use of hormones in the treatment of disease or cancer and also covers other types of hormones like growth hormone. Compare to chemotherapy. HRT does apply to TSs, not only because that is the term always used, but because one is literally replacing androgens with estrogens. Also, since HRT continues throughout a TSs life, including following SRS or castration, it doesn't really make sense to switch between terms. But no, hormone therapy is something completely different. Can we add this back in? Thanks, Paige 17:35 4 Jun 2003 (UTC)

Also, male-to-female transsexual HRT is very much like HRT for postmenopausal women (even more so if menopause was induced by hysterectomy). Transsexual HRT has benefited much from research into postmenopausal HRT. I specifically added the bit about TS HRT because, as Paige stated, it is used exclusively in that context. -- Kimiko 17:42 4 Jun 2003 (UTC)

I'd advise create a separate article Hormone Replacement Therapy in transsexuals then.

As I said, especially for male-to-female HRT there is very much overlap with postmenopausal HRT. After completion of a second puberty, it is even identical to HRT for non-transsexual women who have had hysterectomy. -- Kimiko 17:55 4 Jun 2003 (UTC)

Strange - I've always heard it referred to as "taking hormones" or "hormonal treatment" or "hormone therapy" - never as HRT. Still, I bow to your superior knowledge - please do re-add it. If you could fix the intro as well, that'd be good :) Martin 20:20 4 Jun 2003 (UTC)

HRT is the medical term. I've heard "hormone therapy" and the others, but not very often and only as a short or colloquial form of "HRT". Then again, I'm not (post)menopausal. -- Kimiko 21:13 4 Jun 2003 (UTC)

---

Following the frequently discussed, rarely understood WHI, the term "HRT" is no longer used in mainstream womens health. Rather, "ET" or Estrogen Therapy for Estrogen alone treatments, and "HT" or Hormone Therapy for combination E+P treatments are now standard.

I´m not sure about the terminology but IMO "hormone replacement" covers many more things such as corticoid replacement in Addison´s disease, Thyroxin in hypothyoidism, etc. etc. (perhaps even insulin in diabetes?) Are there other articles or should these matters be added here? Kosebamse 20:33 4 Jun 2003 (UTC)

All of those actually fall under hormone therapy, which is a VERY wide feild and growing rapidly. P.S. Many thanks to Martin and whomever else set up that page! Paige 20:56 4 Jun 2003 (UTC)

I think this may reflect usage in the transexual community, but may not reflect the way the terms are used by the medical community. Certainly the definition of "replacement" as meaning "replacing androgens with estrogens" is not the medical meaning. -- Someone else 21:08 4 Jun 2003 (UTC)

Yes, HRT is the medical term, also used among transsexuals. The 'replacement' in HRT refers to the replacement of hormones that are not produced by the body in sufficient quantities. -- Kimiko 21:13 4 Jun 2003 (UTC)

Oh I see. Didn´t note the subleties of "replacement". In medicine you would probably talk about "substitution", meaning replacing something that is deficient with something of similar effect (e.g. insulin in diabetes, cortisol in Addison´s). So if (or rather, iff) "replacement" does actually have that narrow meaning the other stuff should go somewhere else. Kosebamse 21:15 4 Jun 2003 (UTC)

HRT is the term generally used in medicine for substitution/replenishment of sex hormones. See for example a search of "HRT" on PubMed.

Yes, but "Hormone Replacement Therapy" is but a special instance of "hormone replacement therapy". The same phrase means different things in different contexts. -- Someone else 21:25 4 Jun 2003 (UTC)

Use of the term 'hormone replacement therapy' seems to be rare outside this context. Without further qualification, HRT almost always refers to replacement of sex hormones (usually of the female kinds, but try searching for "HRT testosterone male"). -- Kimiko 21:42 4 Jun 2003 (UTC)

Well but I think "hormone substitution treatment" or something like that would be more precise for the other examples, so I guess we could put these to "hormone therapy" or rather to a page to be linked from there. Kosebamse 21:30 4 Jun 2003 (UTC)

The phrase hormone substitution treatment is certainly not a widely used one. "Hormone replacement therapy" is an ambiguous phrase, referring popularly to "estrogen therapy" and referring medically to any hormone prescribed for a deficiency. I don't see any rationale to separating them, especially as it tends to obscure the fact that it's an ambiguous phrase. -- Someone else 21:39 4 Jun 2003 (UTC)

re latest edition of the article text. Neat solution to this talk page controversy. -- Kimiko 21:52 4 Jun 2003 (UTC)

Agree. So if get you right we should just leave things here? What then (if anything) should go to hormone therapy? Kosebamse 21:49 4 Jun 2003 (UTC)

Other hormone treatments, as indicated by SE's latest edit. For example, insulin, TSH and GH. -- Kimiko 21:52 4 Jun 2003 (UTC)

With the header as it stands now, explaining that the phrase has more than one meaning, it's a reasonable compromise to have this article focus on the more common meaning and have other stuff elsewhere. Though I'd be happier if the other were "hormone replacement therapy" and this were "Hormone Replacement Therapy" <G> (ah, the joys of case-sensitivity) -- Someone else 21:53 4 Jun 2003 (UTC)

Agreed. But having HRT (caps) and hrt (lower case) with different subjects would be way to confusing for casual readers. Heck, it would confuzzle me too. -- Kimiko 21:58 4 Jun 2003 (UTC)

Oh, I wasn't suggesting we do it, only saying I'd be happier if we did. ;) -- Someone else 22:01 4 Jun 2003 (UTC)

Case sensitive disambiguation is the work of the Devil! Martin

---

I'm somewhat distressed by the less-than-NPOV tone of this paragraph:

It has become increasingly clear that oral progestin and equine estrogen pills can increases a number of risks, including the risks of exacerbation of existing liver or gallbladder problems and of dangerous blood clots. Long term use of equine estrogens probably also increases the risk of breast cancer. In women with a uterus, therapy with equine estrogen, unopposed by progesterone, may also increase the risk of uterine cancers. This combination can also effect blood triglyceride levels and so may increase the risk of cardiovascular problems. Although HRT with progestins and equine estrogens was once widely thought to promote cadiovascular health in women, on February 4, 2004, the American Heart Association released guidelines stating that it should no longer be considered as an agent to increase heart health or to decrease the chances of cardiovascular disease.

Some of this content is correct (the AHA guidelines about not using estrogen or HRT for heart health reasons), but some of it is highly slanted against equine estrogens (to be fair, several studies have shown that plant estrogens such as Estrace have less of the inherent risks of Premarin, forming the basis for much of the over-the-counter "menopausal therapies") and the "It has become increasingly clear..." intro smacks of agenda-speak. Perhaps better editing would help ("A number of recent medical studies over the past ten years have found...")? Scarletsmith 18:41, 19 January 2006 (UTC)

Male HRT

Hormone Replacement Therapy (HRT) - Delighted that there is material on this subject. This text, however, reflects the old convention that HRT was strictly applicable to females. The endrocronologists and others working in this field have expanded it to cover the treatment of males and even refer to the age problem of males as "andropause". There are now "andrologists" and others treating "andropause" with HRT. Need an expert to redo this subject.

Aye. Men and women have hormones, and in both cases they decline with ageBoonukem 02:31, 2 January 2007 (UTC)

Celebrity Endorsements

There's no citation for Patti Labelle's endorsement of "natural" progesterone, and I can't find one. I did find this (her renouncement of her paid endorsement for HRT): http://www.yourlawyer.com/articles/read/5929

Moreover, I'm not sure celebrity endorsements are appropriate--borders on advertising. Suzanne Somers is troubling--she profits from books touting "natural" hormones. And she had breast cancer...she did not take her doctors' advice to stop taking the "natural" hormones once she was diagnosed. She did, however, get part of her breast removed and undergo radiation. She also took birth control pills for 20 years... Cindery 23:35, 28 July 2006 (UTC)

NPOV regarding "natural" hormones

HRT is commonly understood to refer to hormone replacement therapy for menopause, involving drugs approved by the FDA. (None of the so-called "natural" hormones were ever approved for use by the FDA for HRT.) This page reads like "HRT vs. "natural" hormones," not as an entry on HRT. (And with a pretty obvious bias in favor of "natural" hormones--the page seems designed to promote "natural" hormones.) "Natural" hormones could be a small subsection of this article, or provide link to page on "natural" hormones. But is is not NPOV re HRT to compare "natural" vs. synthetic all the way through as main thrust.Cindery 23:45, 28 July 2006 (UTC)

I agree with this assessment and think it should be changed to be more NPOV. QuizzicalBee 15:07, 16 April 2007 (UTC)

Bioidentical Hormones

I disagree with the above statements. First, this section header should use the term "bioidentical", rather than "natural" hormones.

The article would benefit from more information about bioidentical HRT, specifically the differences between human and equine hormones. The FDA hasn't approved bioidentical hormones because they are identical to the ones in your body. As I understand it, you can't patent the use of human hormones like that. This is in contrast to HRT drugs like Premarin, which comes from the urine of pregnant horses. Horse estrogens are different than our own.

Wyeth, the maker of Premarin (an HRT drug), has an employee editing this and related pages to disparage bioidentical HRT. The IP is 155.94.62.221 - http://whois.domaintools.com/155.94.62.0, check their edits. There seems to be an active campaign to discredit bioidentical hormones in this article.

The distinction between equine (horse) hormones and human/bioidentical ones needs to be solidified. It should be clearly spelled out that these are hormones from horses. I'd guess that less than half of Americans know the meaning of the term "equine".

Someone attempted to make that distinction clearly in the passage below, but it's not enough. It should be clearly stated that these are hormones from a horse, and are different than human ones. The word "horse" is not mentioned once in the entire article.

Studies finding adverse health effects of equine estrogens and progestins have often been reported, inaccurately, as revealing effects of "estrogen" and "progesterone." It is important to keep this habitual inaccurate generalization in mind in reviewing press reports. On the other hand, creams, gels, etc. containing "biodentical" hormones custom-prepared by compounding pharmacies are not subject to FDA monitoring or regulation, so that doses delivered and hormone blood levels produced are unpredictable and may be highly variable, and there are fewer large scale studies of these items.

Drake 18:05, 15 August 2007 (UTC)

Any problems you are running into with WP:COI or POV-pushing can be dealt with at WP:AIV, though make sure you run through the warning templates before reporting. Also, make sure any comments regards horse versus bioidentical hormones are sourced. The equine comment can be addressed through the use of a piped link. WLU 19:25, 15 August 2007 (UTC)

Testesterone Update

New data from the Nurse's study is now available re testerone and HRT. (It is linked to breast cancer, heart disease, etc.) This needs to be updated here, perhaps with a testerone subsection? Cindery 23:45, 28 July 2006 (UTC)

Should this article be for HRT in men and women?

Someone made a brief attempt to make this article about HRT in men and in women. I changed it back because the info as changed was vague and confusing, but a valid point is raised. While HRT is used almost exclusively to refer to hormone replacement for women, it is true that increasingly, men are being prescribed hormones. Should separate articles be created for both men and women, as well as having an HRT for Transexuals article? Or should these be a sub-heading for this article? Or should they be called something else entirely? When men are prescribed testosterone, is it called "Hormone Replacement Therapy" or "Testosterone Replacement Therapy"? My impression is that it's called "Testosterone Replacement Therapy," meaning that putting that information here would just be confusing, and a separate article for TRT should be created instead, to differentiate the different therapies. QuizzicalBee 15:54, 29 January 2007 (UTC)

water contanimation

like 'the pill', the is evidence HRT also causes water contamination, esp in large cities. Sorry, cannot provide sources. —The preceding unsigned comment was added by 195.27.20.35 (talk) 18:57, 5 February 2007 (UTC).

Category:Human reproduction

I propose removing this article from Category:Human reproduction. I have proposed narrowing the scope of that category at Category talk:Human reproduction. Please comment on the category talk page. Lyrl ^Talk _C 15:01, 17 March 2007 (UTC)

Medline definition

Medline has the following definition[1]:

Hormone Replacement Therapy

Therapeutic use of hormones to alleviate the effects of hormone deficiency. Year introduced: 1999

Under that they have a subhead:

Estrogen Replacement Therapy

The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, DYSPAREUNIA, and progressive development of OSTEOPOROSIS. This may also include the use of progestational agents in combination therapy. Year introduced: 1990

In Wikipedia, Estrogen Replacement Therapy simply redirects to Hormone Replacement Therapy. Do you think the difference between the 2 terms is a distinction worth keeping? Nbauman 19:21, 15 April 2007 (UTC)

I'm unclear about exactly why you are asking this question. I do not think the distinction should be kept in terms of ERT having its own entry. But explaining the distinction in a sentence in the HRT entry could be useful. My impression is that ERT is an antiquated term. When they first started giving menopausal women hormones, it was only estrogen, and therefore the term ERT was used. Later, it became standard to add progestin to the mix and then HRT became standard, but ERT lingered because some women do just take estrogen. But my opinion is that it's unnecessarily specific to say ERT rather than HRT. QuizzicalBee 15:13, 16 April 2007 (UTC)

HRT is a more general term, ERT is a more specific term. ERT is not antiquated; they still use it, as you can see if you search Pubmed for "Estrogen Replacement Therapy [mh]".

I think HRT (generally) and ERT (specifically) are two distinct entities and should be dealt with in separate entries. The main difference is the quality of evidence.

1. ERT as defined above, in postmenopausal women, has many studies, some of them long-term prospective RCTs, with huge numbers of people, which have resulted in strong conclusions at Level I evidence.

1. HRT, as defined above, includes replacement of other hormones, such as thyroxin. Each of those hormones has much less research. It's justified to treat patients without demanding Level I evidence in some cases.

The use of estrogen in XY men who have discordant embryonic development as a method of strengthening female sexual characteristics is significantly different from restoring estrogen to its original levels in post-menopausal women. One big difference is the numbers. Estrogen treatment of men isn't guided by Level I evidence. Another big difference is the purpose -- in women estrogen is supposed to "restore" a "healthy" state, whereas in men it's supposed to bring them into a state that never developed in the first place.

HRT can also refer to replacements of deficient adrenal hormones, thyroid hormones, growth hormones, etc. These treatments are simpler, the results are more obvious, and there's much less debate about them. Most people don't call for large RCTs (there aren't large numbers of patients); they're satisfied with the clinical observation that they seem to work.

However, restoration of testosterone to the levels at younger age, on the analogy of estrogen replacement for women, is a separate situation with much weaker evidence with issues that are different from the other applications, and has the weakest evidence of all.

These and other uses of hormone replacement therapy are so different that they each deserve their own Wikipedia entry. ERT is complicated enough that you could hardly discuss all the issues in a lengthy entry. Nbauman 16:57, 16 April 2007 (UTC)

Research Funding

I believe this statement is inaccurate - "Apart from a few studies funded by the U.S. National Institutes of Health, the overwhelming majority of research on hormone supplementation has been financed by manufacturers..." Wyeth, the maker of both Premarin and Prempro, which were the only hormone products studies, funded a significant part of the study. 72.205.193.253 03:54, 24 April 2007 (UTC)

I think that comment has either NPOV problems, or else it should have references. It's somewhat misleading, too, as it doesn't explain why the big Prempro/Premarin study was so important.QuizzicalBee 16:44, 24 April 2007 (UTC)

It isn't a NPOV if it's true, is it? Why was the Prempro/Premarin study so important? It is routinely referred to in the medical literature as the "gold standard" of hormone replacement research. It cost $750 million dollars and went on for 17 years.

72.205.193.253 17:59, 3 May 2007 (UTC)

No, it's not NPOV if it's true. That's why I said it was either NPOV or it needs references. If there are no references, then there's no proof it's true, and it could therefore very well be an NPOV violation. It might still be an NPOV violation because the comment isn't contextualized--most drug studies are funded by the manufacturers, unfortunately, but the way it's phrased makes it seem like this is an extraordinary circumstance. And the Prempro/Premarin study didn't go on for 17 years.QuizzicalBee 18:09, 3 May 2007 (UTC)

From http://www.nhlbi.nih.gov/whi/

"The WHI was launched in 1991 and consisted of a set of clinical trials and an observational study, which together involved 161,808 generally healthy postmenopausal women.

The clinical trials were designed to test the effects of postmenopausal hormone therapy, diet modification, and calcium and vitamin D supplements on heart disease, fractures, and breast and colorectal cancer.

The hormone trial had two studies: the estrogen-plus-progestin study of women with a uterus and the estrogen-alone study of women without a uterus. (Women with a uterus were given progestin in combination with estrogen, a practice known to prevent endometrial cancer.) In both hormone therapy studies, women were randomly assigned to either the hormone medication being studied or to placebo. Those studies have now ended. The women in these studies are now participating in a follow-up phase, which will last until 2010."

Wyeth provided medication to 161,808 women. At seventeen years, times 12 months, that's over 2 million prescription a year or 34 million in total. Even if they only cost $20 (which they didn't), that's over $600 million. So even a fraction of that is more than a minor grant. 72.205.193.253 23:32, 4 May 2007 (UTC)

You provide some valuable information, but some of your interpolation is not correct. The WHI study has lasted for 17 years, but the hormone study hasn't been going on for 17 years--the hormone study lasted an average of 7 years per woman, and not every woman of the 161,808 was in the study. The WHI is studying lots of different things. Plus, about half of the women who were in the study didn't even receive the hormones--they got placebos. If you look [link at the published results of the study], you'll see that 16,608 women were chosen to be in the Prempro study. 8506 got hormones. These hormones, provided at wholesale cost for 7 years, if we think of the wholesale cost as $5/month, would be $3,572,520. For the Premarin-only study, there were link 11,000 participants, about half of whom got Premarin, the others, placebo. So the cost would be less than 3.5million for them, too. But none of this is the point of my objection--my point was that we need references to support what is said, and an explanation of why the study was important.QuizzicalBee 02:31, 5 May 2007 (UTC)

I did say that "even a fraction of that" taking into account the reductions you cited. Placebo provided by Wyeth would still have the same cost. The cost of the hormone content in the pills is negligible. And I'm sure Wyeth would never agree that the wholesale cost was $5, but that's beside the point. Why was the study important? It is cited literally thousands of times in other peer-reviewed papers, not to mention the media. It is considered by many the gold-standard study on hormone replacement, despite its manifest flaws. I'm not sure how to answer that question. Why was the Warren Connission important? What measure of importance would convince you? The announcement of the stopping of the study was front page news in The New York Times, complete with a picture of Dr. Rowan Chlebowski MD/PhD, an endocrinologist/biostatistician who ran the statistical part of the study. Neil Raden 05:16, 6 May 2007 (UTC)

Wiley Protocol

This is inappropriate. There are hundreds of hormone replacement therapies, why single out one that is statistically insignificant, perhaps no more than 0.1% of the total HRT use? And the proper place to raise the issue about whether or not the Wiley Protocol is controversial is in the article about the Wiley Protocol. Neil Raden 05:21, 6 May 2007 (UTC)

Section from page

I removed the following section from the page - it's pretty much unreferenced (the links included don't link directly to the studies, just non-specific pages and a conference. The wording is off ('staggering'?), it discusses a specific type of HRT without citation, the explanations look like original research without a reference, and it appears to push bioidentical hormones, which violates WP:NPOV. At minimum, it needs sources, and probably a re-write. It can't go on the page as is. WLU 18:57, 1 August 2007 (UTC)

A study [2] by M.D. Anderson reported in a medical conference [3] in San Antonio Texas in December 2006 looked at new cancer diagnoses in the U.S. in 2003, the year following the initial reports of clotting in connection with use of PremPro. A staggering 7% drop in new diagnoses of breast cancer in the U.S. was noted in 2003, compared with 2002 levels. One third of the decrease could have been related to a reduced number of mammographies. But the balance appeared to be related to widespread cessation of PremPro use. Reductions were by far the sharpest in women over 50, the age group among whom prior PremPro use (and thus discontinuation) was most likely. This and other studies suggest that the shift away from the proprietary PremPro combination was a key factor. These studies are consistent with the possibility that replacing PremPro with bioidentical hormones could reduce cancer risks. Long-term use of hormone combinations other than PremPro has already been found to be associated with lowered incidence of cancer. For example a large 2004 population study of women who used birth control pills found a reduced risk of heart disease and stroke and an overall decreased risk of cancer. In this study, women who had used birth control pills at some point in their lives were noted to have an 8% lower risk of heart disease, no increased risk of breast cancer, and a 7% lower overall cancer risk including significant reductions in ovarian and colon cancer. This 2004 study of the contraceptive pill's protective effects followed smaller studies that had found a slight breast cancer promotion associated with use of certain oral contraceptives. The favorable picture of contraceptive benefits emerged from the 2004 study's analysis of the very large body data collected from the over 160,000 women who had participated in the Women's Health Initiative study.

Ad copy via censorship of Premarin / PremPro dangers

The fact that cancer rates dropped after women massively stopped taking Premarin and PremPro, with footnotes, has been removed.

Cancer rates massively dropped.

What's left now is this bowdlerized paragraph, with the salient drop in cancer rates deleted:

After the increased clotting found in the first WHI results was reported in 2002, a large number of women who had been taking the proprietary mixtures of equine estrogens and progestins studied (Prempro) ceased filling their prescriptions. Some simply stopped all hormones, and others switched to bioidentical hormones.[citation needed] The number of Prempro prescriptions filled was abruptly cut almost in half. —Preceding unsigned comment added by 67.101.142.251 (talk) 15:51, 18 October 2008 (UTC)

What about men?

Isn't there HRT for the andropause or for biological men whose levels are too low?--87.162.48.4 (talk) 19:19, 6 May 2009 (UTC)

• yes, and this has been talked about extensively before, and that's why this page, specifying "menopause," which is a medical term used only for women, was created. For a page for biological men, you can go to androgen replacement therapy, which was created for that purpose. QuizzicalBee (talk) 02:22, 7 May 2009 (UTC)

Wyeth blanketed the scientific literature with pro- PremPro "Reviews" without revealing sponsorship.

Drug Maker Said to Pay Ghostwriters for Journal Articles By DUFF WILSON Published: December 12, 2008

http://www.nytimes.com/2008/12/12/business/13wyeth.html?partner=rss&emc=rss

... "One article was published as an “Editors’ Choice” feature in May 2003 in The American Journal of Obstetrics and Gynecology, more than a year after a big federal study called the Women’s Health Initiative linked Wyeth’s Prempro, a combination of estrogen and progestin, to breast cancer. The May 2003 article said there was “no definitive evidence” that progestins cause breast cancer and added that hormone users had a better chance of surviving cancer."

By covertly controlling the literature, Wyeth put itself in a position to obscure the risks of its proprietary equine xenoestrogens and chemically-altered progestins, and thus maintain market share by selling them through doctors who had not been impartially informed of the risks to women who were also in the dark.

Crucially, this body of controlled literature could be written to obscure the higher risks of Wyeth's proprietary preparations in comparison with bio-identical human hormone supplementation. —Preceding unsigned comment added by 64.105.0.154 (talk) 14:21, 6 August 2009 (UTC)

Dangers of Hormone Replacment Therapy

I know there is solid literature on the the dangers of hormone replacement therapy during menopause and I'm surprised that there is neither discussion nor dissent on the page. I'm adding a few links here and will work on documenting them better so they can be incorporated into the page itself:

1) CBS News reported in 2003 that at least one Women's Health Initiative study was halted because the therapy was correlated with an increase in breast cancer while providing no benefit against heart disease and stroke.

2) The Women's Health Initiative of the NIH has a comprehensive Q&A about the findings of their study: http://www.nhlbi.nih.gov/whi/whi_faq.htm

References

Amanda bee (talk) —Preceding comment was added at 16:41, 25 February 2008 (UTC)

These studies showed Wyeth's proprietary preparations were dangerous. NIH-funded studies have shown that bio-identical esterified estrogens, for example, did not cause the clots caused by Wyeth's PremPro. —Preceding unsigned comment added by 64.105.0.154 (talk) 14:23, 6 August 2009 (UTC)

"Menopausal hormone therapy” not “hormone replacement therapy" is the term now preferred by the NIH

According to the New York Times,

"The National Institutes of Health ultimately decided to start using the term “menopausal hormone therapy” instead of “hormone replacement therapy,” says Marcia L. Stefanick, a professor of medicine at the Stanford University medical school who was principal investigator on the Women’s Health Initiative study at her institution."

References

—Preceding unsigned comment added by 66.167.61.219 (talk) 23:29, 12 December 2009 (UTC)

Wyeth's documents reveal deflecting doctors and users from cancer concerns of PremPro

According to the New York Times, court documents obtained via freedom of information request paint Wyeth as company that

"over several decades, spent tens of millions of dollars on influential physicians, professional medical societies, scientific publications, courses and celebrity ads, inundating doctors and patients with a sea of positive preventive health messages that plaintiffs' lawyers say deflected users' attention from cancer concerns."

Over 13,000 people have sued Wyeth over cancer allegedly caused by Prempro. —Preceding unsigned comment added by Ocdcntx (talk • contribs) 22:04, 1 February 2010 (UTC)

Wyeth acted with reckless disregard to the risk of injury in marketing dangerous Premarin

Another Loss for Pfizer in Drug Suits

http://www.nytimes.com/2009/11/24/business/24wyeth.html?fta=y

By DUFF WILSON

Published: November 23, 2009

"... On Monday a jury in Philadelphia Common Pleas Court awarded $28 million in punitive damages to Donna Kendall of Decatur, Ill., whose breast cancer was found after she had taken hormone drugs for 11 years. The jury had already given her $6.3 million in compensatory damages.

Punitive damages in Pennsylvania require a finding of “wanton and reckless” conduct. The jurors heard testimony that Wyeth paid consultants and ghostwriters of medical journal articles to play down concerns about breast cancer, as well as testimony that Pharmacia did not study known risks. The punitive award was split $16 million for Wyeth and $12 million for Pharmacia.

After that ruling was made public, Sandra M. Moss, the judge who leads the complex litigation program at the Philadelphia court, unsealed a $75 million punitive damage award from last month in a case brought against Wyeth by Connie Barton of Peoria, Ill. She was also awarded $3.7 million in compensatory damages previously made public."

"... Esther E. Berezofsky, a lawyer for one of the women who won the awards in Philadelphia said Monday, 'This is just the tip of the iceberg.'

She said that in cases that had reached jury judgments, women with breast cancer had won damages in 10 of the 12 hormone drug cases, although many are on appeal. Ms. Berezofsky also said a federal appeals court decision in St. Louis this month had significantly improved plaintiffs’ chances of receiving punitive damages and winning appeals.

In that decision, a three-judge panel of the United States Court of Appeals for the Eighth Circuit overturned an award of $27 million for an Arkansas woman, citing improper testimony by an expert witness. But the court ordered a new trial on punitive damages. The judges’ ruling said 'there was sufficient evidence upon which a jury could conclude that Wyeth acted with reckless disregard to the risk of injury.'" —Preceding unsigned comment added by 66.167.61.214 (talk) 17:15, 18 April 2010 (UTC)

TSEC - Tissue Selective Estrogen Complex

To whom it may concern,

There is no page on wikipedia about potential future HRT related therapies such as TSEC.

I don't know enough about TSEC nor do I have the time to write an article. But anything is greatly appreciated.

Thank you. —Preceding unsigned comment added by 90.212.29.19 (talk) 22:25, 12 February 2011 (UTC)

Bunch of posts by Ocdnctx

Unlike PremPro, which causes heart attacks & strokes, the study group receiving hormone replacement replacement with estradiol (a bioidentical hormone) and norethisterone acetate had lower risk of CAD ) - PMID 11486242

PMID 11486242

Sanderson, Haines, Yeung, Yip, Tang, Yim, Jorgensen, Woo.

Anti-ischemic action of estrogen-progestogen continuous combined hormone replacement therapy in postmenopausal women with established angina pectoris: a randomized, placebo-controlled, double-blind, parallel-group trial.

J Cardiovasc Pharmacol.

2001 Sep;38(3):372-83.

Abstract

The benefit of treating postmenopausal women with established cardiovascular disease with combined estrogen-progestogen hormone replacement therapy (HRT) is controversial. This study investigated the effect of treatment with estradiol and norethisterone acetate on exercise tolerance and on the frequency and severity of ischemic attacks in postmenopausal women with stable angina pectoris. A total of 74 Chinese women were recruited for this 16-week double-blind, placebo-controlled trial. They were randomly allocated into two groups; one group received placebo/placebo/placebo and the other group received placebo/estrogen-progestogen/placebo. Estrogen-progestogen continuous combined HRT increased both time to 1-mm ST depression (99.1 s, p < 0.05) compared with a mean decrease of 22.9 s with placebo (p < 0.05), and total exercise duration also showed a significant increase (32.7 s, p < 0.05) after treatment compared with placebo (2.5 s, p < 0.05). In addition, the total number of ischemic events/24 h during ambulatory electrocardiographic monitoring decreased by 0.82 events after treatment (p < 0.05) compared with an increase in the placebo group (0.94), a highly significant difference (p = 0.006). These results suggest that the administration of this particular combined hormone replacement preparation may have a beneficial effect on myocardial ischemia in postmenopausal women with established coronary disease.

If the evidence provided by this large observational study showing the relatively lower risk of women receiving bioidentical progesterone is less than conclusive, it is evidence. And thus it undercuts the assertion that there is "no" evidence of a superior risk profile for bioidentical progesterone.

Ocdnctx (talk) 01:14, 10 April 2013 (UTC)

Superior compliance and efficacy of continuous combined oral estrogen-progestogen replacement therapy in postmenopausal women. PMID 7503183

Comment: patient acceptance is directly related to quality of life, as well as improved health outcomes. The women on the continuous progestogen regimen had similar improvement in climacteric symptoms, with less discontinuation pointing to better higher quality of life (less bleeding). They also increased bone mineral density, while those in the intermittent progesterone or the placebo groups did not.

PMID 7503183

Dören, Reuther, Minne, Schneider

Superior compliance and efficacy of continuous combined oral estrogen-progestogen replacement therapy in postmenopausal women.

Am J Obstet Gynecol. 1995 Nov;173(5):1446-51.

Department of Obstetrics and Gynecology, Westfälische Wilhelms-Universität, Münster, Germany.

Abstract

OBJECTIVE:

We assessed compliance, relief of climacteric symptoms, and impact on lumbar bone mineral density in two groups of 140 patients treated with a sequential estrogen-progestogen or a continuous combined replacement therapy in comparison with controls.

STUDY DESIGN:

Patients were randomized to 2 mg of estradiol valerate daily and 5 mg of medroxyprogesterone acetate daily for 12 days per month sequentially to induce withdrawal bleeding (group A) or 2 mg of estradiol, 1 mg of estriol, and 1 mg of norethisterone acetate daily continuously to maintain amenorrhea (group B) or a control group (group C).

RESULTS:

Compliance was 93% after 1 year and 73% after 2 years in group B and 66% and 49% in group A after 1 and 2 years, respectively. Improvement of climacteric symptoms was similar in groups A and B. Uterine bleeding in 24% of patients in group A and 3% in group B was the most frequent reason for discontinuation of drug intake. Only continuous combined therapy (group B) increased bone mineral density after 1 and 2 years compared with baseline: +13% and 17% (p = 0.01). In groups A and C no significant changes in bone mineral density were recorded. Compliance was unrelated to the age of menopause.

CONCLUSION:

Continuous combined therapy is superior to sequential estrogen progestogen replacement in compliance and prevention of bone loss but not with regard to relief of climacteric symptoms.

—Preceding unsigned comment added by Ocdnctx (talk • contribs) 15:19, 1 May 2011 (UTC)

Before continuous combined therapy, complex hyperplasia was found in 21 women but all had normal histological results after nine months on continuous combined hormone replacement

"… Before the continuous combined therapy was started, complex hyperplasia was detected in 21 women who had taken sequential hormone replacement therapy before the study and in one who had taken unopposed oestrogen. All of these women had normal results on histological examination of endometrial tissue after nine months of treatment with continuous combined hormone replacement therapy, and hyperplasia did not recur after up to five years of treatment."

PMID 12153918

doi: 10.1136/bmj.325.7358.239

Full Free Text:

http://www.bmj.com/content/325/7358/239.1.full

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC117635/?tool=pubmed

Wells, Sturdee, Barlow, Ulrich, O'Brien, Campbell, Vessey, Bragg.

Effect on endometrium of long term treatment with continuous combined oestrogen-progestogen replacement therapy: follow up study.

Academic Unit of Pathology, Section of Oncology and Pathology, Division of Genomic Medicine, University of Sheffield Medical School, Sheffield S10 2RX, UK. m.wells@sheffield.ac.uk

BMJ. 2002 Aug 3;325(7358):239. Abstract

OBJECTIVE:

To determine effects of five years of treatment with an oral continuous combined regimen of 2 mg 17beta-oestradiol and 1 mg norethisterone acetate on endometrial histology in postmenopausal women.

DESIGN:

Follow up study in postmenopausal women. Setting: 31 menopause clinics in the United Kingdom.

PARTICIPANTS:

534 postmenopausal women, all with an intact uterus, who had completed nine months of treatment with oral continuous combined 2 mg 17beta-oestradiol and 1 mg norethisterone acetate agreed to take part in a long term follow up study. Women were assigned to different groups on the basis of the treatment status immediately before entering the original study: 360 women had taken sequential oestrogen-progestogen hormone replacement therapy, 164 had taken no hormone replacement therapy, and 10 had taken unopposed oestrogen therapy. Methods: Endometrial aspiration specimens were taken before the women started the continuous combined regimen, after 9 and 24-36 months, and at the end of the five year treatment period or on withdrawal from the study.

MAIN OUTCOME MEASURE:

Results of endometrial histology.

RESULTS:

The duration of treatment with continuous combined hormone replacement therapy was 4.4 (range 1.1-5.9) years. Data on endometrial specimens were available for 526 women after nine months of treatment, 465 women after 24-36 months of treatment, and 398 women who completed the five years treatment (345 women) or were withdrawn between the two latter visits for biopsies (53 women). No cases of endometrial hyperplasia or malignancy were detected at biopsy; 69% of women had an endometrium classified as atrophic or unassessable on completion of the study or withdrawal from it. Before the continuous combined therapy was started, complex hyperplasia was detected in 21 women who had taken sequential hormone replacement therapy before the study and in one who had taken unopposed oestrogen. All of these women had normal results on histological examination of endometrial tissue after nine months of treatment with continuous combined hormone replacement therapy, and hyperplasia did not recur after up to five years of treatment.

CONCLUSIONS:

Long term treatment (for up to five years) with continuous combined hormone replacement therapy containing oestradiol 2 mg and norethisterone 1 mg daily was associated with neither endometrial hyperplasia nor malignancy. In women who had complex hyperplasia during previous sequential or unopposed regimens, the endometrium returned to normal during treatment with continuous combined hormone replacement therapy. These findings provide reassurance about the long term safety of this continuous combined regimen in terms of the endometrium.

Comment in BMJ. 2002 Aug 3;325(7358):231-2. Full Free Text of Comment: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123759/?tool=pubmed

Ocdnctx (talk • contribs) 15:52, 1 May 2011 (UTC)

2009 Cochrane review: hyperplasia risk low dose estrogen continuously combined with 1 mg norethisterone acetate or 1.5 mg medroxyprogesterone acetate is not significantly different from placebo

"Unopposed estrogen is associated with increased risk of endometrial hyperplasia at all doses, and durations of therapy between one and three years. For women with a uterus the risk of endometrial hyperplasia with hormone therapy comprising low dose estrogen continuously combined with a minimum of 1 mg norethisterone acetate or 1.5 mg medroxyprogesterone acetate is not significantly different from placebo (1mg NETA: OR=0.04 (0 to 2.8); 1.5mg MPA: no hyperplasia events)."

Furness, Roberts, Marjoribanks J, Lethaby A, Hickey M, Farquhar C.

Cochrane Database Syst Rev. 2009 Apr 15;(2):CD000402.

Hormone therapy in postmenopausal women and risk of endometrial hyperplasia.

PMID 19370558

Full Free Text: http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD000402/frame.html;jsessionid=BA2F3152FB46AD13F3D77A151F87787C.d02t01

Obstetrics & Gynaecology, University of Auckland , 85 Park Rd, Grafton , Private Bag 92019, Auckland, New Zealand. suefurness@gmail.com

Abstract

BACKGROUND:

Declining circulating estrogen levels around the time of the menopause can induce unacceptable symptoms that affect the health and well being of women. Hormone therapy (both unopposed estrogen and estrogen/progestogen combinations) is an effective treatment for these symptoms, but is associated with risk of harms. Guidelines recommend that hormone therapy be given at the lowest effective dose and treatment should be reviewed regularly. The aim of this review is to identify the minimum dose(s) of progestogen required to be added to estrogen so that the rate of endometrial hyperplasia is not increased compared to placebo.

OBJECTIVES:

The objective of this review is to assess which hormone therapy regimens provide effective protection against the development of endometrial hyperplasia and/or carcinoma.

SEARCH STRATEGY:

We searched the Cochrane Menstrual Disorders and Subfertility Group trials register (searched January 2008), The Cochrane Library (Issue 1, 2008), MEDLINE (1966 to May 2008), EMBASE (1980 to May 2008), Current Contents (1993 to May 2008), Biological Abstracts (1969 to 2008), Social Sciences Index (1980 to May 2008), PsycINFO (1972 to May 2008) and CINAHL (1982 to May 2008). Attempts were made to identify trials from citation lists of reviews and studies retrieved, and drug companies were contacted for unpublished data.

SELECTION CRITERIA:

Randomised comparisons of unopposed estrogen therapy, combined continuous estrogen-progestogen therapy and/or sequential estrogen-progestogen therapy with each other or placebo, administered over a minimum period of twelve months. Incidence of endometrial hyperplasia/carcinoma assessed by a biopsy at the end of treatment was a required outcome. Data on adherence to therapy, rates of additional interventions, and withdrawals due to adverse events were also extracted.

DATA COLLECTION AND ANALYSIS:

In this substantive update, forty five studies were included. Odds ratios were calculated for dichotomous outcomes. The small numbers of studies in each comparison and the clinical heterogeneity precluded meta analysis for many outcomes.

MAIN RESULTS:

Unopposed estrogen is associated with increased risk of endometrial hyperplasia at all doses, and durations of therapy between one and three years. For women with a uterus the risk of endometrial hyperplasia with hormone therapy comprising low dose estrogen continuously combined with a minimum of 1 mg norethisterone acetate or 1.5 mg medroxyprogesterone acetate is not significantly different from placebo (1mg NETA: OR=0.04 (0 to 2.8); 1.5mg MPA: no hyperplasia events).

AUTHORS' CONCLUSIONS:

Hormone therapy for postmenopausal women with an intact uterus should comprise both estrogen and progestogen to reduce the risk of endometrial hyperplasia.

Update of

Cochrane Database Syst Rev. 2004;(3):CD000402.

PMID 19370558

Ocdnctx (talk) 22:42, 19 February 2013 (UTC)

JAMA study: Conjugated Equine Estrogen (CEE) group OR 1.78 higher for clots compared with bioidentical esterified estrogen group. PMID 15467060

Esterified Estrogens and Conjugated Equine Estrogens and the Risk of Venous Thrombosis

Conclusion

Our finding that conjugated equine estrogen but not esterified estrogen was associated with venous thrombotic risk needs to be replicated and may have implications for the choice of hormones in perimenopausal and postmenopausal women.

JAMA. 2004;292:1581-1587. Vol. 292 No. 13, October 6, 2004

FULL FREE TEXT:

http://jama.jamanetwork.com/article.aspx?articleid=199532

PMID 15467060

Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study PMC 2211383

Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study

Progesterone, which is bioidentical, combined with estrogen, did not raise breast cancer risk (RR 1.00), in sharp contrast to most non-bioidentical progestagens (RR 1.69). The estrogen–dydrogesterone combination was closer to the risk of bioidentical estrogen, (RR 1.16)

Agnès Fournier, Franco Berrino, Françoise Clavel-Chapelon

"The association of estrogen-progestagen combinations with breast cancer risk varied significantly according to the type of progestagen: the relative risk was 1.00 (0.83–1.22) for estrogen–progesterone, 1.16 (0.94–1.43) for estrogen–dydrogesterone, and 1.69 (1.50–1.91) for estrogen combined with other progestagens."

...

"These findings suggest that the choice of the progestagen component in combined HRT is of importance regarding breast cancer risk; it could be preferable to use progesterone or dydrogesterone."

PMC 2211383

HALMS: HALMS201813

estrogen alone use by postmenopausal women with prior hysterectomy in the WHI trial did not substantially interfere with breast cancer detection and statistically significantly decreased the risk of breast cancer.

Underscores that the non-bioidentical progestin MPA used in the WHI study was the cause of the raised breast cancer risk seen in the women given MPA, and not the proprietary equine estrogen used (Premarin).

Rowan T. Chlebowski, Garnet L. Anderson

Menopausal Hormone Therapy and Breast Cancer

J Natl Cancer Inst. 2012;104(7):517-527.

Abstract

… In the WHI trial evaluating estrogen plus progestin in postmenopausal women with an intact uterus, combined hormone therapy statistically significantly increased the risk of breast cancer and hindered breast cancer detection, leading to delayed diagnosis and a statistically significant increase in breast cancer mortality. By contrast, estrogen alone use by postmenopausal women with prior hysterectomy in the WHI trial did not substantially interfere with breast cancer detection and statistically significantly decreased the risk of breast cancer. ...

http://www.medscape.com/viewarticle/761673

Move info here from Menopause?

There is a long section in the Menopause article about HRT as used for menopause. I don't currently know whether or not it contains some info that is not in this article. However, since we have this article and it is in pretty good shape, I am thinking that the section in the Menopause article should be cut down a lot, and the reader referred to this article for more info. Does anyone have an opinion on that suggestion? Would anyone who knows a fair amount about this topic like to make the transfer of info (or deletion of info) or like to help with that editing, assuming they think it is a good idea to do this? Thanks, Invertzoo (talk) 17:17, 10 February 2014 (UTC)

From old talk page

Hormone replacement therapy (testosterone)

Just to serve notice that such an article is needed, jaybe titled Hormone replacement therapy (men) or Hormone replacement therapy (males) since boys are often prescribed for dwarfism etc. I redirect Testosterone replacement therapy here because none of the entries here are suitable; transgering is not replacement of testosterone, it is induction....this could probably be raised on a WikiProject talkpage, I just don't know which one and where to look.Skookum1 (talk) 17:09, 29 November 2008 (UTC)

I guess that can redirect to Testosterone's subsection - where Testosterone replacement therapy redirects to. Seems like it should have a separate article, though, because of the others listed here.Skookum1 (talk) 21:12, 7 December 2008 (UTC)

This article should be replaced with a disambiguation page

The meager information and stub-level quality here adds little, but delays or diverts persons seeking information about specific hormone therapies, especially for menopause.

If the article is kept, a scope note is needed at the top, with a link to Hormone replacement therapy (menopause), which is what the overwhelming majority of searchers are looking for. Estrogen Therapy should also redirect to a disambiguation page or to Hormone replacement therapy (menopause).

Test blocker or Testosterone blocker

Anyone know what this is? Do we have an article about it? Could it redirect here in a section? Janae Marie Kroc mentions it in an interview and I was not sure where to link to explain it. Seems like estrogen supplementation and testosterone blocking would be two halves of the same coin in MtF hormonal treatments.

Is the opposite true? Are estrogen blockers (is est blocker ever used for short?) used in addition to test supplementation in FtM transitions? 184.145.18.50 (talk) 18:57, 11 February 2016 (UTC)

Cardiovascular Effects

What are the mechanisms by RTC acts?--Emmymorri98 (talk) 05:45, 29 January 2019 (UTC)

The lead

I enjoy sandwiches, keep in mind that the lead is meant to summarize the article per WP:Lead. It shouldn't be too short.

I removed your "more sections" tag since the article has enough sections and since too many sections can make an article look bigger than it actually is from the table of contents and make the article more difficult to navigate through. Flyer22 Reborn (talk) 07:54, 21 February 2019 (UTC)

As for organization of the article, keep WP:MEDSECTIONS in mind. Flyer22 Reborn (talk) 07:57, 21 February 2019 (UTC)

Hello Flyer22 Reborn, I agree it does need to be reorganized and worked on further. Thus far was focusing on clearing out primary research and relocating and simplifying the extreme detail regarding the WHI that was in the intro before. Those header tags weren't mine actually, but I agree about that as well. I enjoy sandwiches (talk) 16:14, 21 February 2019 (UTC)

I enjoy sandwiches, my mistake; I see that you didn't add the "more sections" tag. Flyer22 Reborn (talk) 07:14, 23 February 2019 (UTC)

No worries. I have continued to work on the article and trimmed a lot of the primary research and updated with more recent opinion and better reviews from more impactful journals. Also reorganized sections as per medsections. There is still much to do. I enjoy sandwiches (talk) 06:51, 2 March 2019 (UTC)

Strange title - is this "postmenopausal hormone therapy"?

Currently this Wikipedia article is titled, "Hormone replacement therapy (menopause)". Is this content about "postmenopausal hormone therapy"? Blue Rasberry (talk) 18:06, 19 April 2017 (UTC)

• Support User:Bluerasberry. A shorter title that means the same. Doc James (talk · contribs · email) 03:43, 19 December 2017 (UTC)

Bluerasberry and Doc James, regarding this move, "hormone replacement therapy" is the WP:Common name for this topic. I addressed Medgirl131 about this last year. Given the common name, why should we go with "postmenopausal hormone therapy" as the title? Even "Menopausal hormone therapy" would be a better title since this therapy is not solely for postmenopausal women. I'd also like to know why Bluerasberry found the title odd, unless referring to the parentheses. I'm thinking that this needs to go through the WP:Requested moves process. Will link to the matter at WP:Med. Flyer22 Reborn (talk) 07:50, 1 July 2018 (UTC)

I'm thinking that this article should either be titled "Hormone replacement therapy" (and that the Hormone replacement therapy page, which is hardly any different than a disambiguation page, should be moved to "Hormone replacement therapy (disambiguation)") or the article should be titled "Menopausal hormone therapy." But again, when sources state "hormone replacement therapy," they are usually talking about it in relation to menopause. Not in relation to transgender treatment or anything else. Flyer22 Reborn (talk) 08:17, 1 July 2018 (UTC)

User:Flyer22 Reborn moving to HRT sounds reasonable as that is the main meaning with the current HRT article moved to a disambig. Doc James (talk · contribs · email) 08:24, 1 July 2018 (UTC)

@Flyer22 Reborn: I thought the parentheses were odd. I can support another title.

We have another article, Hormone replacement therapy, which is the placeholder for explaining the general concept and redirecting to other types of hormone replacement therapy. I just checked the audience traffic. The main article got about 15,000 views last month while each of the three subtopics got about 4,000 views last month. This is supporting evidence that the topic are of equal interest and that no one of them should get the article title "hormone replacement therapy" in favor of the others, assuming that all of them use this name.

I would agree to a move if anyone demonstrated a common name. I am not sure what names are used for this topic. Maybe "menopausal hormone therapy" works. "Postmenopausal hormone therapy" is a term in use but probably not a concept to separate from "menopausal hormone therapy". Here are some sources which use "postmenopausal hormone therapy":

• Cleveland Clinic - Post Menopausal Hormone Replacement Therapy
• ACOG - Postmenopausal Estrogen Therapy
• Google identified most cited paper (20 citations) 2004 - Postmenopausal Hormone Therapy

This is a weak case for "postmenopausal hormone therapy". Google shows another paper cited by 670 others which uses "menopausal Hormone Therapy". Other popular and recent papers use that name, so that could be the right name. Should we go with "menopausal hormone therapy", or should we look more at the other hormone therapy concepts more to see which names are best for each of them? Blue Rasberry (talk) 11:25, 1 July 2018 (UTC)

Bluerasberry, look at the literature on "hormone replacement therapy." The overwhelming majority of the time that term is used, it's in reference to menopause. Even a simple search on regular Google shows this. The transgender aspect is not really "replacement therapy" since it's not replacing something that was there (at least when thinking of "replacement" as "restoration"). The transgender titles were recently changed so that they don't have "replacement" in them anyway. The only other listing on the Hormone replacement therapy page (which, again, is a page that is essentially a disambiguation page already) is androgen replacement therapy. It's easy to see that androgen replacement therapy is not what is usually meant by the words "hormone replacement therapy." I'm quite sure that the vast majority of our readers who look at the Hormone replacement therapy page are looking for the menopausal topic. On a side note: Since this page is on my watchlist, there is no need to ping me to it. Flyer22 Reborn (talk) 15:54, 1 July 2018 (UTC)

@Flyer22 Reborn: This issue is getting complicated. I can agree with you that the medical focus and use is about treatment of menopausal women. I am less certain about how to reconcile the traffic numbers. It could be that women are less likely to seek information about hormone therapy and that the popular media is directly lots of people to read about transgender issues.

Can you help me interpret the Wikipedia traffic? My read on this is that all these topics are of near equal popularity among our readers. If that is the case, and if all of these have lately been called "hormone replacement therapy", then I would want to see some reason about why to favor one topic over the others.

Our current taxonony is hormone therapy --> hormone replacement therapy --> menopause + transgender. I would not object to your sorting things out upstream to eliminate this downstream ambiguity, but while we are associating all these topics together as instances of hormone replacement therapy, I am not seeing a reason to make a choice. What do you think? Blue Rasberry (talk) 17:01, 1 July 2018 (UTC)

Bluerasberry, hey again. Like I noted before, there is no need to ping me to this page. I don't see this title topic as complicated. We should be adhering to WP:Common name and WP:Primary topic. I can cite source upon source that defines "hormone replacement therapy" as solely referring to menopause. What sources are there restricting hormone replacement therapy to transgender hormone therapy, or solely to androgen replacement therapy? What sources are there saying that all three fall under "hormone replacement therapy"? You stated, "The main article got about 15,000 views last month while each of the three subtopics got about 4,000 views last month." By "main article," I take it you mean the Hormone replacement therapy article? If so, that to me does not prove that the other two aspects are as popular. What that shows me is that "hormone replacement therapy," which almost always refers to menopause, is the far more popular topic. The other two topics (not three since this page is one of the three listings there) are simply not referred to as hormone replacement therapy (not usually). It makes sense to me that this page, without its common name title, would get views equal to the other two pages. I don't know what exactly is going on with the traffic, which might also be due to how we are using wikilinks for the hormone stuff, and I'd rather not go by our own original research on that. As you may remember, we did a test sometime back to see what the primary meaning of testosterone was, although I already knew what the primary meaning was and stated so. We can do the same in this case, by moving this article to "Hormone replacement therapy" and seeing which article gets the most views, but I'd rather not do a test. I'd rather just move the article. We can still observe, but yeah. Plus, after that, if someone is going to argue that "Hormone replacement therapy" gets the most views because editors are looking for the other two aspects as much as the menopause aspect, what's the point? Flyer22 Reborn (talk) 17:32, 1 July 2018 (UTC)

A quick inquiry with a famous web search engine indicates that, in the trans* context, "hormone therapy" is somewhat more common than "hormone replacement therapy". If "HRT" is reserved for the general concept, it would be possible to clearly disambiguate these pages with titles such as Postmenopausal hormone replacement therapy and Hormone therapy for transgender. WhatamIdoing (talk) 23:54, 1 July 2018 (UTC)

Flyer I need to leave this one to you. There is an on-wiki precedent for calling multiple treatments "hormone replacement therapy" but I do not see evidence that this was ever correct by the source material. I am too unsure to take a position on details but also I think any outcome to exit ambiguity and into more clear terms would be useful to readers.

I am committed to some other projects right now and cannot talk this through to the end. Even if I did carry this discussion further I suspect your position would be the correct choice at the end because you are making a good case from several directions. You have my support to proceed with the title changes you are recommending. Blue Rasberry (talk) 01:37, 3 July 2018 (UTC)

I think hormone replacement therapy is a better title for this. Replacement seems to indicate the replacement of endogenous hormones. Trans hormone therapy is the administration of different hormones, and I don't think it referring to in the same way. Natureium (talk) 13:16, 3 July 2018 (UTC)

agree w/ Natureium--Ozzie10aaaa (talk) 14:40, 3 July 2018 (UTC)

Doc James, it appears that we have a consensus to move the article to "Hormone replacement therapy." As for the one currently titled "Hormone replacement therapy," maybe it should be deleted since the other two listings there are not usually called that? Or maybe that article should be moved to "Hormone therapy"? Natureium, any thoughts on what to do with the other article? Should we call it "Hormone replacement therapy (disambiguation)," "Hormone therapy," delete it, or what? Flyer22 Reborn (talk) 06:10, 4 July 2018 (UTC)

Happy with whatever people decide. Doc James (talk · contribs · email) 10:10, 4 July 2018 (UTC)

There's a sort-of list at Hormone therapy and I think merging the 2 would be best. Natureium (talk) 18:42, 4 July 2018 (UTC)

Natureium, ah, so we already have a Hormone therapy article. I think I forget about that. So you are proposing that we merge the stuff currently seen at the Hormone replacement therapy article to the Hormone therapy article, and retitle "Postmenopausal hormone therapy" so that it's "Hormone replacement therapy"? If so, I agree. And, again, we have consensus to go ahead and rename this article "Hormone replacement therapy." Via email, I know that Medgirl131 would be okay with that too. Flyer22 Reborn (talk) 08:16, 5 July 2018 (UTC)

Okay. Doc James, per above, and as seen here and here, I merged the content that was in the Hormone replacement therapy article to the Hormone therapy article, and redirected "Hormone replacement therapy" here. All that is left to do is to retitle the "Postmenopausal hormone therapy" article "Hormone replacement therapy," and have "Postmenopausal hormone therapy" redirect here. This requires administrative action. I cannot do it myself. And there currently is no option for me to move this article anyway. I'm sure the option exists for administrators. Flyer22 Reborn (talk) 06:13, 7 July 2018 (UTC)

Done. Doc James (talk · contribs · email) 10:36, 7 July 2018 (UTC)

Did you think about whether the talk pages should move as well? WhatamIdoing (talk) 21:46, 8 July 2018 (UTC)

Move it aswell and add the three old comments below. Doc James (talk · contribs · email) 03:37, 9 July 2018 (UTC)

I've gone and moved the old article/talk page history to preserve it at Hormone replacement and Talk:Hormone replacement. Graham87 10:37, 30 October 2020 (UTC)

Requested move of Transgender hormone therapy (male-to-female)

A proposal to rename Transgender hormone therapy (male-to-female) (as well as the parallel article "Transgender hormone therapy (female-to-male) ) is being discussed. Your feedback would be appreciated at Talk:Transgender hormone therapy (male-to-female)#Requested move 15 February 2021. Thanks, Mathglot (talk) 19:32, 19 February 2021 (UTC)

Expansion and editing

Significantly expanded the article with WHI updates to 2021, HRT use for patients after different cancers (ovarian, colorectal, etc), neurodegenerative disorders, cyclic/continuous regimen differences, increased FDA regulatory overight for bioidentical compounding, and persistent uncertainty over bioidentical hormone therapy including Richard Neapolitan's intricate Cox regression analysis in PLoS One. Going forward I intend to broaden sections discussing androgenic therapy and sexual dysfunction as these have been ignored almost entirely. I excluded Holtorf's review as it was a poor analysis in a borderline journal financial bias with significant financial conflicts of interest. I do not have access to the National Academies of Sciences chapter from 2020, so if anyone else does would like to see this added. Stil much work to do. I enjoy sandwiches (talk) 16:49, 28 February 2021 (UTC)

Mention of transgender hormone therapy?

I notice this article has no mention of hormone replacement therapy for transgender people. I am aware that a separate article exists at Transgender hormone therapy; however, I wonder if there should be some mention of the topic within this article, possibly even within the lead section. Within transgender communities, it is common for hormone therapy for trans women to be called HRT, and it was my assumption that trans HRT is relatively similar to menopausal HRT in terms of the medications that are typically used. However, I am not very knowledgeable about this field, so I wanted to ask for others' input instead of making any bold changes. Could others more knowledgeable about this field please weigh in? Thanks, IagoQnsi (talk) 06:05, 2 May 2019 (UTC)

See the #Strange title - is this "postmenopausal hormone therapy"? discussion above. If you present some WP:MEDRS-compliant source showing hormone replacement therapy referring to transgender hormone therapy, we will consider adding something to the article about it. Flyer22 Reborn (talk) 08:35, 2 May 2019 (UTC)

In the meantime, you can add a WP:See also section in the article for the Transgender hormone therapy article. Flyer22 Reborn (talk) 08:39, 2 May 2019 (UTC)

Does the Journal of Medical Ethics count? See Ashley, F. (2019). Gatekeeping hormone replacement therapy for transgender patients is dehumanising. Journal of medical ethics, 45(7), 480-482. http://dx.doi.org/10.1136/medethics-2018-105293 Woood (talk) 01:47, 29 May 2021 (UTC)