Systematic review: hormone therapy in women with premature ovarian insufficiency
Posted November 4, 2022
A systematic review with meta-analysis conducted by the INCT Hormona research group of Universidade Federal de Minas Gerais (UFMG) primarily aimed to find, select, and aggregate data from the best cohort studies and clinical trials on hormone therapy in women with premature ovarian insufficiency (POI) and/or surgical removal of both ovaries before menopause.
According to the Center coordinator, Prof. Fernando Reis, POI involves situations when ovarian hormones should be naturally present, but insufficiency occurs, and it is a consensus that these hormones should be restored, using medications. “The question we wanted to answer is whether the benefits were quantified and whether there is a difference in the benefit among different formulations,” the specialist said.
Overall, reports of 28 studies were included, with a total of 4,004 participants with POI from diverse etiologies, of whom 3,785 received hormone therapies and 219 received calcium supplementation, vitamin D, placebo, or no treatment. The article explains that hormone therapy was superior to non-treatment, placebo, calcitriol, or calcium in preserving bone mineral density (BMD). Still according to the survey, hormone therapy was associated with up to 80% reduction in the prevalence of hot flushes and with stability or improvement in the quality of life scores.
According to Prof. Reis, the analyzed studies were of good quality and revealed that treating ovarian insufficiency with continuous hormone replacement reduces hot flushes and improves quality of life. “Furthermore, it protect bones and preserves uterine volume, which may be important in a future pregnancy using a donor egg,” he explains. However, the systematic review shows more studies are needed to reassure the long-term safety of this therapy and to assess its possible impact on the risk of bone fractures and cardiovascular events.
The article Hormone therapy in women with premature ovarian insufficiency: a systematic review and meta-analysis may be accessed at the link: https://www.rbmojournal.com/article/S1472-6483(22)00085-2/fulltext.