Bioidentical Hormones - U.S. Senate Special Committee on Aging
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Bioidentical Hormones - U.S. Senate Special Committee on Aging

Bioidentical Hormones - U.S. Senate Special Committee on Aging Bioidentical Hormones - U.S. Senate Special Committee on Aging

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207 HORMONE THERAPY USE AND RISK OF CARDIOVASCULAR DISEASE ting of randomized controlled Irials, thus avoiding some of the potential biases of observational studies. The by distantce front menopause, with no apparent increase in CHD risk for women close to menopause, and particularly high a Wnnhatta rontnr & Canin ned entewag fund rig fit Paee. Nneof ate tle, authors reported disnnoures. F.ading/Sappont The Womens Heatth IicitatiT prt- conclusions relating to harm in women more distant from menopause are more robust because of the larger numbers of clinical evenis- The conclusions based on the analyses of nsks in women who are distant from menopause and have vasomotor symptoms We did not identify any subgroup with reduced risk of CHD, although total mortality was reduced gcrn isniaded by tie Natuial Heart. Lang. aid lied Irirnnte, NabtcetInitutr tof Heath. OnaDrp.Aentof Heatah iad Hnac Scramc.. The study daugsee sap. plied bi Wyeth Rseasch (st D-iOds. Pat. Rote ofth Sp-nean: The Natlaalinrdtiirna of Heaith had inpuSt int dign and ondact of the study: Wi- Ierlin management, anis and interpreratlbn ot women closer to menopause are less robust due to smaller numhers, as are among women aged 50 to 59 years. The findings regarding potential modifying the data: nnd prepna-iiin of the ciacarrpt. Wyeth did not participate rn any aspeat af thed rec the analyses itivolving vasomnotor symptoms. Time of menopause may not be accurately ascertained in effects of vasomotor symptoms warrant further study. The absence of excess absolute risk of CHD and the suggestion Wmt t-nctigaties Prnxant Olfti. Nirattl Heart. Lung. and Ilood Institrte Bathscda. Md ttitabniai NatIl. Mtqcns Rassara. Shan Ludbm. bada Ptn. lean McGo-an women who hase undergone a hystereciomy. Nonadherence may have allected the results At the end of the of reduced total mortality in younger women offers some reassurance that hormones remain a reasonable option for the Lesni Ford, and Nanny Glelr). CitnkI Cirdinting Censter: Fred Hatchnrsn CanitinseaRCh Center. Seatte. wash lRoss P-tiirn Ga.nrt Ardensan. Aedrea LCcrni Chadies L. Koupnr. trials, 54% of participants were no longer taking CEE and 42% were no short-ierm treatment of menopausal symptoms, but does not necessarily im- Lrg,. Ruth E. PattrA-n.wAn;nre cei.): Wake Faret Wni-rty School of Medicine Winsltn tSme, NC (Saty Shsrkert) Medial Research Labs, Higiand longer taking CEE + MPA. The results are derived from relatively short durations of treatment but the average of 4 0o 5 Years of receiving treatment in the trials is longer than most women ply an absence of harm over prolonged petiods of hormone use. In contrast, risk of stroke did not depend on years since menopause or the presence of vasomoloe symptoms. The findings are consis- Heights Ky ff- Stric)t Uciaenity of Caidinna at Sacn Fr-nasca, he Fracusco ISteten C-mgins). CI0ninI Centers Albert Ensta Coliege of Medince ,rma. NY ISyhia Wassertheil-Snlert) layltn Calg at Meddnfe. Hearten. Tea tecider Haysi. Drtighm and W-iren s Hospital. Harvend Medicai School, Bostn. Mass ionen Mansa l-ie Un.iwvould need for treatment of vasomotor symptoms. Multiple statistical tests were performed, raising a distinct possibility that several of the positive findings occurred by chance. The possibility of type I error is increased by the fact that these analyses were partly stimulated by the initial findings from the trials. The results are dependent on the analytic approach used, which differs in this compared with previous publicationis from the WHI trials. In previous WHI studies using continuous variables, the significance of the interaction of years since hysierectomy on CHD in the trial of CEE was Pwty, P-idess, Rt tientA..We R. A5Uf ;: Ersy unstent with current recommendations that iet. Atlanta. cratcanene Philips); Fred Hachihn- hormurone therapy be used in the shortson Cann-e Research Center, Seattie, Wash IhrSLy ee-sford)i Grage Washhngton Uineity Midiat term for relief of moderate or severe va- Cser. Waslingitn, DC tIadirh Hse.): La. Agetes somotor symptoms, but not in the longer blomedicil Research Ins'ite at Habo-iUCLA MA did- term for prevention ofcardiovAsculardisctl Center, T.n-ran Ceidf (Ra.ian Chteb.nkki)t Kaiin Pecanne-te Center for Health Research. PoateascrNN Land, Ore (Etnlyc Whitlock): Cirns Peraninate Drcisi- of Res-h, Oaklnd. 1 Caif (8ette caa); ta.rMtAiasI Naed Hert Laard Mlirid i Medialctl degenf iwaansn. tatrknaaknn etianetaan stitute, snieda, Md (Dr R.-a)aw; Fred Hutchirmn ky Kotcihm-n MedSt Renr- h Irfitrt./Haard tir- C-r. DhCesCerr,,rSiaiter .Wtsh (D P.prnirind aerit Wainsoe-n. DC (lCub V. Hianrd.: North- LaCani nd Ms Wa), OW.i; n of prerennef n M i idme, iestern Unetniy, Chtaago/Nacstn, IIl (Lnda Van Br a nd wr-e Hospital Hm3 Motinal drhool, H-a) Rush Mednat GCnter,. Chitag, ll (iensyBlacirk) lostO Mass (D, Macson; DOep.rrc tsao ObsttreisSttaaoad Pierentan Reeaih Ceeter. Stafed. Caart aiWd Gynmoagy and wane- s Healuh. Abeer Ent (Marcda L. Stitnnick); State Unhenity ot New Yoek caotlge of Madaie. New Youk, NY tD, Bradi: On- at Stcy Brnok (Dt othy Lt.n) OhhI State Urinepar.tnr t Obftebtns and Gyneciogy. Mednai Colhsity, Coibasc(nRei-iclackr nl, Untenity a Aa- lege of Wrsaatsii Mhuukee (D, 6naie0i DOstn bmn. Ibisminghm (C-a E. Lesis). Uariebtyif Ard- of W rmc Is Health Iftern Medrice, Maso COd,, nu. Tucs.n/Phoenib hansen T i-iSfrd.) Univrenity Scottsidae. Art tO, Ki)t mex' centee tar crinn Re- atlaitainol8utaea NYtieanwacsaatid-Mndbnt-in search, ersrty of Minnesot, Mirnetratr(3s Mar- yesib of Caftia at Dnais. Streream tstnter Rob- P= 06 compared with P= .15 for years since menopause in the current analysis using coded vanables.' In the trial of CEE + MPA, the significance for years since menopause changed from P=.33 to P= 05.' Only one form of oral estrogen and one forni of oral progestin taken daily were included in the trials, and it may be that different results wotld have been obtained if other regimens (eg, trantsdermal estraaht ,e-t etatM ietd .Sitalrd un-nnity. Palo bnsct Uniersity of C.asisif a, erine (F. Atac Hub- Alto, Ca e(Dr stefakk). bell, Unirenity of CaQfan. Los Angites l H1ard Aithor Canaribtions Dr R-.soaw had Nttl ..i. to hrddl: UIneri-ty oi C.itf-ai at Stn Diegoi LaJorar al of the data rn the study nd taker respao-inlity tor Chlai Vera iRfbert 0. Langer): Unenisity of COnn- the atetiy if the data and the acaracy of ttie data nab. Cmdnnti, Ohio IMargery Geat; U eety nof aaasir Fkik5a. G. kA/ajacksoasc (Marian. ULnadce, Unstcytozpt i nddeiarg: Rasrac, PnemteMaan, Yenity of Hlial. Honolulu (DIad Cuabl; Utnhenity arad, annabei of aea, i...a COti/D-O npet (Robett Walla.cd Ue - Acquiritan oa data. Pentice. Macsan, lrid, K., esity of Maiarh--ettFta.n CUMni Wicestniia- mCacin, Steacick. dith Ockean); Unrnenity of Medicine and Dnatrisy racsr n-dcrteipreeatiauto Riaraaa, P-sati, of N-w kney. Nsrawrk (Nonmen Lasser). Un-inty Main, Wa, Barad, 8anitbi. LUcrei Mgalis. of Miami. Manti, R (Mary in O Saunan;) Unher- omatcng oa tU.e .nnAnarpt Rosoarou w . CK. sIty of Miaerata. Mnnapails (Kicen Margolis). Ulu- Cerra revisiao at tir inauiip t ar icprtani is erety of Nevada. Rern (Robert BncrX. Unenity Wite-trat ca-tetr Prentice, Ma.can. Wvu, iarad, of Nbtah C-Iinc. Chapel Hit IGerardb Heiss)i Un- icceaher, Ka, LaCoil, Magolis Stf tnickt etity of Pittsburgh. Pittsburgh. Pt (Lrwis K.Rei: Umdiol, progesterone, or cyclic therapy) SlartisicaiNrlysis: P-entce. W, LaCri. nensay of reT-esese Mniphis (Kteare C. latrsaci were tested. These analyses, although not defini- Obtamned f-edmag: Rosauw, Prenetie Macsrn. Stefninck. Adccniairative. technical, or atecal supporit U-neriy it Tenoas Health SMnnie Cente,. Sac Antono (Robert rnyskhi: Unhnsity if VWIrani.. Madian (CGoia C. Start.) Wake Forest Untaersity Scnan tive, suggest that the health cotisequences of hormone therapy may vary Rac.s Prentice, Maniac Study ripe-isiiei Rassaw. Magais. Ftn ilt Distlsaens On LaCntit repoted sedg as of Medicine, Wlnston-Saer. NC (Denlse 8nndsl Wayne State nneanty Schoi of Medikle/Hatani Hospital. Detrnit. Mich (Susr.n H-ndnit. 1476 IAMA, Apriln. N007-Vot 297. No. 13(Renntedl r2007 Ain-tnria Mediea Aansoati... Atf eUhms 6 ened. Doinetinded fbee ww.jana m.m at Nationatl Institute of lth. on Apnl 5. 2007

208 HORMONE THERAPY USE AND RISK OF CARDIOVASCULAR DISEASE REFERENCES 11. RossorrwEAndsonGL, Peice RL. etaipwrt- 20. Heckbert SR. Weiss, Koepsef TD etDat f.ora 1. dB-nett-Connor E. Grdy D. Ho-n. rfpIec inlg Groop for the Womenes Health InItative Sn noflor tonolerapyirnrelaootothertIof irnd 1. Oarrett-Comr h .Grady 0 Hordrrrne replace- ' Inestigato Rstis and efits of estgen pluspro detmyoc adlletanntirinpostreoepaoajwomen 2s therapys rdoa. adotherconnde riood.t ' o ifo healthy pIstr pa- sal- woeren. JAMA. Arch Aaea toWerss Med. Rev Pubfic 1997 Health. 7:1331336 P t1 1995:19.55-727 2002.280 321 333. 21.oronthipdowtgrecetcrnag- 2. H.HeyOS.Gradyf D.nB Tet at. Rars udorradtla 12. Andersn GL., Liraoes M. Anoa AR, clt .1 gaphoctoals. A.rriladial th95,76.06C.92C. Ofeshogenpl.oyrogentrrrforcodary prcetion omn Health WIntativ Steerfn Corrirritee. 22. SlgeotC.ReeolA.OeareepPMo~ealCholeterol of cooay heats donas a PoohnnoPaoslworoai Elffct of roogtoaed onpor tihogon in posner- isret-id e.traIs CoIlbaoators Efficay and, safety JdMdO 1998.2800605-613. p-oaf wome with hyoterctowy. JdMA. 2004. olcdhoLtescero-owerigtratw Ptproop vetremta 3. Macson E HoJ. Tonnon KC. et at. Womeis 291:1701.1712. aYalps of data fo 90.056 par°opefto in 14 ran- Healthr iolctrv Irnetigatos Esoogen plot pinoe- 13. C.ODE.RegreosnaoasnaodldeahMbLJRstat downed thaoat o stalno Larcet 20D5:366:t267tin ad MsI of o-ory hears done. N Eni Med. SocB. 1972;34:107.220. 1270. 2003.349:523.534. 14. DowyeioKM, .taodotrmCl, Sans M tcrCN. 4. ff01, flyer Longer 23. Water D. Maroon DD. Alderoa 10. at EL, HO.a), at. C-alaated en at Effect, 36. of Caohd waS thicok-o and p- once -eas at- honnoirteennthesaw aidanoaodannarmos Aqa Ingensandthe2006 eh oro30no6y hetsnadoaea e4,ndW oophorectony. Ami lfpidniol. 2002:156:438- oapplenentoooncantn isyaterooderonsi pootmeno Anch We.r Med. 2006.166:357-3653 444 p.uta women.arad-oned contrlled Onal 1444AA 5. Pre-ti RL. Lnger RD. Stefak ML. eaA. Con- 15. Mad WIl Starer CC, Xlng M. Shope D, Lobo 2002,2E8:2432-2440 bhaed anasis of Wo .ens Health niathe obeva- RA, Hoas HI EEl-atedsohdlnoatthe-d rostss- 24. HernrftoRehorlofLorrdrnoo.rtaE htnail ad tfincat Uia data on postoonnopasas Kr- nortated with ophoredoy is elated to tone sie Effects of mibogoe, rptacrMoot on the prgresson of rone therapy and cardio-asc-lr disease. Ar J nropaertherthantypeofoeiropa.eFerhlSteo. coronaryaer200eroNun nMed 210343: Epidemmo. 2006:163:569-593. 2004;82:391.397. 522-529 6. Grdotero F, Chrkson TS, Manso JE. Understnd. 16. Grodsbein F. Monsrn IE, Coldit. GA. Wilett WC. 25. Rostom IE. Coronary heart di.ease In eenoing the divergent data on postmopaaa hoone SpenerFE. SLamperj Aproge. obsernatonl patio women twplicatooms of prnyip and secondtheapy. N Engl I Med. 2003:340:645-650. totyofpostomenopaa salhocmorse therpynedpmorep aZypnentbontnita of horm u Mbtor43s. 2005.51: 7. Mndednohn ME KEarm OH Motecotr ond otlo- preobonofcardio-nscrdsdtsr.Ano-ncemoMed. 91-63. tar bans ofrcdonascirgender ddferocesSctee. 200k.133933.941. 26. Hannan SM, 8dnon EA, Cedar Mt. et a. KEEP: 20"3:308:1583.1587. 17. GrodstenF.MensonJEStarpferin.Pxosteno the Kronos Early Estrogen Prenntin Stady 0. Grodotoin F. Ma nso JE, Sta-pfer to. Hormone postuu hormone ux mid scondary p-etooon of Cliactenc. 2005;83-12. therapy sod coronary heart disease: the rote of tiame cnroiyenentsoithe ies HeatthadStdyapeospcc- 27. Cnical Tnors Web Sde. ELITE: Eady Vern Late sarrmenopas-cnd age at h-mnooemioat- J Wo. tnobtematto tlstudy. Ann kto Med. 2001:135: lobtornmro To With Esa.diol tNCT03- 145t17i wen http Health ItarL-rrot. 206.tO:35-044 t.0. IlriaoiiahatRnAconised 9. tanoary Wa 16,2007. scrroscrS.tHendru S.tamadrerycetat 1B. HUkbefi SR. Kapan RC, Wes NS, d id Risk of 28. US P-eoncine Senicr Task Foce. Hormone Etfect of citroyco pi. progesbo on sthoke is rernrrentocorrreyenenffin rtaorn toctcaodrecen thUerapy htnthepreoon ofrdnrniccondikonshpostpnsbnenpaosal wonie: ti Womens Health isffatosofpost .menopaaoaheotonefleopy.Arch menoypaot -en -cdommedns flme tohe US Irboto :.candonindbiLJAMd.200320.2673-2684. Inkm Med. 2001:16151709-1713. Pr-eoto SosoelTo rF-oeoto Md. 25, 10. HeOdno SLWWaosreeid-Smotle S. tohnon KC, 19. AlcndeKP.NewbyLK.HokimpAS.cad. Ic- 142.055-860. etal. Etectsofco. goted eane trogeo on- sroe UAWonolomothcrapy aft.atemyocanditl e- 29. ACOG Tkth Fore on Horone Therapy. Hoin the Womees3 Health Goatoronhosteoithanioeoardlamentsdorno tInitiativ maneOerapy. Obtet GyneiOr. 20D04.lasopp: ItS- 2006.113 2425-2434. fntlo,-p JiterdoAlgardiol 2001t30.17.7 131 t7 02007 Asoectcas MedIl AS~mineos. All fighoes - dmeo. SRepcfntdt JAMAs. hp-il 4. 200-A-cl 297. No. 13 14PP Downloaded fmm owsjsratcom as Ndonatotl Irtsmt of Hlds, 09 Apdil 5, 2007

208<br />

HORMONE THERAPY USE AND RISK OF CARDIOVASCULAR DISEASE<br />

REFERENCES 11. RossorrwEAnds<strong>on</strong>GL, Peice RL. etaipwrt- 20. Heckbert SR. Weiss, Koepsef TD etDat f.ora<br />

1. dB-nett-C<strong>on</strong>nor E. Grdy D. Ho-n. rfpIec inlg Groop for the Womenes Health InItative Sn noflor t<strong>on</strong>olerapyirnrelaootothertIof irnd<br />

1. Oarrett-Comr h .Grady 0 Hordrrrne replace- ' Inestigato Rstis and efits of estgen pluspro detmyoc adlletanntirinpostreoepaoajwomen<br />

2s therapys rdoa. adotherc<strong>on</strong>nde riood.t ' o ifo healthy pIstr pa- sal- woeren. JAMA. Arch<br />

Aaea<br />

toWerss Med.<br />

Rev Pubfic<br />

1997<br />

Health.<br />

7:1331336 P t1<br />

1995:19.55-727 2002.280 321 333. 21.or<strong>on</strong>thipdowtgrecetcrnag-<br />

2. H.HeyOS.Gradyf D.nB Tet at. Rars udorradtla 12. Andersn GL., Liraoes M. Anoa AR, clt .1 gaphoctoals. A.rriladial th95,76.06C.92C.<br />

Ofeshogenpl.oyrogentrrrforcodary prceti<strong>on</strong> omn Health WIntativ Steerfn Corrirritee. 22. SlgeotC.ReeolA.OeareepPMo~ealCholeterol<br />

of cooay heats d<strong>on</strong>as a PoohnnoPaoslworoai Elffct of roogtoaed <strong>on</strong>por tihog<strong>on</strong> in posner- isret-id e.traIs CoIlbaoators Efficay and, safety<br />

JdMdO 1998.2800605-613. p-oaf wome with hyoterctowy. JdMA. 2004. olcdhoLtescero-owerigtratw Ptproop vetremta<br />

3. Macs<strong>on</strong> E HoJ. T<strong>on</strong>n<strong>on</strong> KC. et at. Womeis 291:1701.1712. aYalps of data fo 90.056 par°opefto in 14 ran-<br />

Healthr iolctrv Irnetigatos Esoogen plot pinoe- 13. C.ODE.RegreosnaoasnaodldeahMbLJRstat downed thaoat o stalno Larcet 20D5:366:t267tin<br />

ad MsI of o-ory hears d<strong>on</strong>e. N Eni Med. SocB. 1972;34:107.220. 1270.<br />

2003.349:523.534. 14. DowyeioKM, .taodotrmCl, Sans M tcrCN.<br />

4. ff01,<br />

flyer<br />

L<strong>on</strong>ger<br />

23. Water<br />

D. Maro<strong>on</strong><br />

DD. Alderoa<br />

10. at<br />

EL, HO.a),<br />

at. C-alaated en at Effect,<br />

36.<br />

of<br />

Caohd waS thicok-o and p- <strong>on</strong>ce -eas at- h<strong>on</strong>noirteennthesaw aidanoaodannarmos<br />

Aqa Ingensandthe2006 eh<br />

oro30no6y hetsnadoaea e4,ndW oophorect<strong>on</strong>y. Ami lfpidniol. 2002:156:438- oapplenentoo<strong>on</strong>cantn isyaterooder<strong>on</strong>si pootmeno<br />

Anch We.r Med. 2006.166:357-3653 444 p.uta women.arad-<strong>on</strong>ed c<strong>on</strong>trlled Onal 1444AA<br />

5. Pre-ti RL. Lnger RD. Stefak ML. eaA. C<strong>on</strong>- 15. Mad WIl Starer CC, Xlng M. Shope D, Lobo 2002,2E8:2432-2440<br />

bhaed anasis of Wo .ens Health niathe obeva- RA, Hoas HI EEl-atedsohdlnoatthe-d rostss- 24. HernrftoRehorlofLorrdrnoo.rtaE<br />

htnail ad tfincat Uia data <strong>on</strong> posto<strong>on</strong>nopasas Kr- nortated with ophoredoy is elated to t<strong>on</strong>e sie Effects of mibogoe, rptacrMoot <strong>on</strong> the prgress<strong>on</strong> of<br />

r<strong>on</strong>e therapy and cardio-asc-lr disease. Ar J nropaertherthantypeofoeiropa.eFerhlSteo. cor<strong>on</strong>aryaer200eroNun nMed 210343:<br />

Epidemmo. 2006:163:569-593. 2004;82:391.397. 522-529<br />

6. Grdotero F, Chrks<strong>on</strong> TS, Manso JE. Understnd. 16. Grodsbein F. M<strong>on</strong>srn IE, Coldit. GA. Wilett WC. 25. Rostom IE. Cor<strong>on</strong>ary heart di.ease In eenoing<br />

the divergent data <strong>on</strong> postmopaaa ho<strong>on</strong>e SpenerFE. SLamperj Aproge. obsernat<strong>on</strong>l patio women twplicatooms of prnyip and sec<strong>on</strong>dtheapy.<br />

N Engl I Med. 2003:340:645-650. totyofpostomenopaa salhocmorse therpynedpmorep aZypnentb<strong>on</strong>tnita of horm u Mbtor43s. 2005.51:<br />

7. Mndednohn ME KEarm OH Motecotr <strong>on</strong>d otlo- preob<strong>on</strong>ofcardio-nscrdsdtsr.Ano-ncemoMed. 91-63.<br />

tar bans ofrcd<strong>on</strong>ascirgender ddferocesSctee. 200k.133933.941. 26. Hannan SM, 8dn<strong>on</strong> EA, Cedar Mt. et a. KEEP:<br />

20"3:308:1583.1587. 17. GrodstenF.Mens<strong>on</strong>JEStarpferin.Pxosteno the Kr<strong>on</strong>os Early Estrogen Prenntin Stady<br />

0. Grodotoin F. Ma nso JE, Sta-pfer to. Horm<strong>on</strong>e postuu horm<strong>on</strong>e ux mid sc<strong>on</strong>dary p-etoo<strong>on</strong> of Cliactenc. 2005;83-12.<br />

therapy sod cor<strong>on</strong>ary heart disease: the rote of tiame cnroiyenentsoithe ies HeatthadStdyapeospcc- 27. Cnical Tnors Web Sde. ELITE: Eady Vern Late<br />

sarrmenopas-cnd age at h-mnooemioat- J Wo. tnobtematto tlstudy. Ann kto Med. 2001:135: lobtornmro To With Esa.diol tNCT03- 145t17i<br />

wen<br />

http<br />

Health ItarL-rrot. 206.tO:35-044 t.0. IlriaoiiahatRnAc<strong>on</strong>ised<br />

9.<br />

tanoary<br />

Wa<br />

16,2007.<br />

scrroscrS.tHendru S.tamadrerycetat 1B. HUkbefi SR. Kapan RC, Wes NS, d id Risk of 28. US P-e<strong>on</strong>cine Senicr Task Foce. Horm<strong>on</strong>e<br />

Etfect of citroyco pi. progesbo <strong>on</strong> sthoke is rernrrentocorrreyenenffin rtaorn toctcaodrecen thUerapy htnthepreo<strong>on</strong> ofrdnrnicc<strong>on</strong>dik<strong>on</strong>shpostpnsbnenpaosal<br />

w<strong>on</strong>ie: ti Womens Health isffatosofpost .menopaaoaheot<strong>on</strong>efleopy.Arch menoypaot -en -cdommedns flme tohe US<br />

Irboto :.cand<strong>on</strong>indbiLJAMd.200320.2673-2684. Inkm Med. 2001:16151709-1713. Pr-eoto SosoelTo rF-oeoto Md. 25,<br />

10. HeOdno SLWWaosreeid-Smotle S. tohn<strong>on</strong> KC, 19. AlcndeKP.NewbyLK.HokimpAS.cad. Ic- 142.055-860.<br />

etal. Etectsofco. goted eane trogeo <strong>on</strong>- sroe UAW<strong>on</strong>olomothcrapy aft.atemyocanditl e- 29. ACOG Tkth Fore <strong>on</strong> Hor<strong>on</strong>e Therapy. Hoin<br />

the Womees3 Health Goator<strong>on</strong>hosteoithanioeoardlamentsdorno tInitiativ<br />

maneOerapy. Obtet GyneiOr. 20D04.lasopp: ItS-<br />

2006.113 2425-2434. fntlo,-p JiterdoAlgardiol 2001t30.17.7 131 t7<br />

02007 Asoectcas MedIl AS~mineos. All fighoes - dmeo. SRepcfntdt JAMAs. hp-il 4. 200-A-cl 297. No. 13 14PP<br />

Downloaded fmm owsjsratcom as Nd<strong>on</strong>atotl Irtsmt of Hlds, 09 Apdil 5, 2007

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