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Shifts in endocrine homeostasis and preventive hormone replacement therapy: extending the Women’s Health Initiative globally

Overview of attention for article published in Global Health Research and Policy, July 2016
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Title
Shifts in endocrine homeostasis and preventive hormone replacement therapy: extending the Women’s Health Initiative globally
Published in
Global Health Research and Policy, July 2016
DOI 10.1186/s41256-016-0009-4
Pubmed ID
Authors

Jacob D. Ball, Xinguang Chen

Abstract

Reducing disease risk for women after menopause is global health issue. A major portion of the Women's Health Initiative (WHI) consisted of two clinical trials involving 161,809 post-menopausal women aged 50-79 that tested the effect of hormone replacement therapy (HRT) on reducing cardiovascular disease and other secondary outcomes. Previous analyses of the data reveal that HRT should not be recommended for post-menopausal women, but show potential benefits for younger women. Thus, there may be a critical period just prior to or during the early stages of menopause where HRT could be both safe and beneficial. Menopause marks the beginning of a process of non-reversible reduction in estrogen by which estrogen levels decline progressively, followed by a reduction in estrogen receptors. This results in periods of hormone-receptor imbalances, exacerbating the effects of lower serum estrogen and is considered the primarily endocrinal source of menopause symptoms. Eventually a hormone-receptor balance is achieved at a lower level.Here, we purport that the negative outcomes from WHI trials were primarily due to the fact preventive HRT was initiated in women who had already achieved hormone-receptor equilibrium at lower hormonal levels. We argue for further HRT clinical trials in women at varying stages of menopause, including pre-menopause and early menopause, and in women from different countries. Variation across countries and subgroups in how women experience menopause and perceive menopause symptoms suggest that biocultural differences should be considered in both study design and measurement approaches to test the effectiveness of HRT. Particularly, we recommend longitudinal studies to assess changes in hormonal level over time, and to detect the "most effective period" for HRT to reduce health risk for women going through the whole menopause period.

Mendeley readers

The data shown below were compiled from readership statistics for 2 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 2 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 2 100%
Researcher 1 50%
Readers by discipline Count As %
Medicine and Dentistry 3 150%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 September 2016.
All research outputs
#8,486,189
of 9,727,301 outputs
Outputs from Global Health Research and Policy
#25
of 25 outputs
Outputs of similar age
#215,674
of 258,088 outputs
Outputs of similar age from Global Health Research and Policy
#3
of 3 outputs
Altmetric has tracked 9,727,301 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 25 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.9. This one scored the same or higher as 0 of them.
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