文章基本信息

标题：Exogenous Hormone Use: Oral Contraceptives, Postmenopausal Hormone Therapy, and Health Outcomes in the Nurses’ Health Study
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作者：Shilpa N. Bhupathiraju ; Francine Grodstein ; Meir J. Stampfer 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2016
卷号：106
期号：9
页码：1631-1637
DOI：10.2105/AJPH.2016.303349
语种：English
出版社：American Public Health Association
摘要：Objectives . To review the contribution of the Nurses’ Health Study (NHS) to our understanding of the complex relationship between exogenous hormones and health outcomes in women. Methods . We performed a narrative review of the publications of the NHS and NHS II from 1976 to 2016. Results . Oral contraceptive and postmenopausal hormone use were studied in relation to major health outcomes, including cardiovascular disease and cancer. Current or recent oral contraceptive use is associated with a higher risk of cardiovascular disease (mainly among smokers), melanoma, and breast cancer, and a lower risk of colorectal and ovarian cancer. Although hormone therapy is not indicated primarily for chronic disease prevention, findings from the NHS and a recent analysis of the Women’s Health Initiative indicate that younger women who are closer to menopause onset have a more favorable risk–benefit profile than do older women from use of hormone therapy for relief of vasomotor symptoms. Conclusions . With updated information on hormone use, lifestyle factors, and other variables, the NHS and NHS II continue to contribute to our understanding of the complex relationship between exogenous hormones and health outcomes in women. Women of childbearing age and those in the postmenopausal period constitute a major proportion of the total population. In 2012, 75.4 million women in the United States were in the reproductive age range of 15 to 50 years, 1 and as of 2010, approximately 64 million women in the United States were postmenopausal. 2 Among fertile women, oral contraceptives (OCs) are among the most effective and popular forms of contraception, with more than 80% of sexually active women aged 15 to 44 years reporting their use. 3 Because of their widespread use as well as numerous case reports of various side effects, the Nurses’ Health Study (NHS) was established to gain insights into the long-term health consequences of OC use. In addition, the NHS evaluated health effects of postmenopausal estrogens and combination estrogen and progestogens. Because the NHS recruited women aged 30 to 55 years at baseline in 1976, it could not examine the effects of OC use during early reproductive life. As a result, the NHS II was established to include a cohort of younger women who started using OCs during adolescence or early adulthood. We have summarized data from the NHS and NHS II on the links of OC and postmenopausal hormone therapy (HT) use with chronic disease risk.