WOMEN 'S HEALTH AND MENOPAUSE : - National Heart, Lung ...

TABLE 1–2 (continued)
Possible Benefits
Neurologic function and
mental health*
Eye*
Colorectal cancer*†
Possible Risks
Period-like symptoms,
including vaginal
bleeding
Mastalgia
CHD events
Stroke
Regimen
Estrogen Alone Estrogen Plus Progestin
Possible preservation of certain cognitive
skills during the period immediately
after induced menopause [B] and during
the aging process [C]; possible reduction
in risk for Alzheimer’s disease with
replacement therapy begun after
menopause [C], with no effect when
begun after the onset of dementia symptoms
[B]; possible benefit in certain
sleep disorders occurring during the climacteric
[C]; possible positive effect on
mood [B]
Little evidence of an effect on age-related
maculopathy, cataract, and dry eye
[C]
Possible reduction in risk
Vaginal bleeding may occur [A]
Significant increase in breast tenderness
[A]
Apparent increase in risk in the first 1 or
2 years of therapy [A]; no definitive evidence-based
rationale to recommend for
prevention of disease
Conflicting results; no overall effect on
stroke risk [B] or possible increase in
risk and possible decrease in stroke
mortality [C]
Possible preservation of certain cognitive
skills during the aging process [C]; possible
reduction in risk for Alzheimer’s disease
with therapy begun after menopause
[C]; possible benefit in certain sleep disorders
occurring during the climacteric [C];
possible positive effect on mood [C]
Same [C]
Same, but less information available
May improve, remain the same, or worsen
depending on the specific formulation
(e.g., MPA versus norethindrone acetate),
dose, or schedule (sequential versus combined
continuous) of the progestin [A]
Same or increased discomfort [A]
Same
Same
5