Clinical and molecular solutions to the puzzling controversies of hormone replacement therapy

Research output: Chapter in Book/Report/Conference proceedingChapter


Menopausal hormone replacement therapy (HRT) and its health outcomes have been the subjects of extensive investigation; the results of these however are highly inconclusive. Today, it is considered that the effect of HRT is a complex pattern of the mysterious mixture of risks and benefits and the use of this therapy is not evaluated as safety prevention for chronic diseases. This conclusion implies the unawareness of the crucial role of estrogens in the surveillance of cellular health based on the misinterpretation of clinical and experimental results. Estrogens and their receptor system have biologically pivotal role favored by evolution as a means of integration of all cellular functions serving the survival and reproduction of individuals. A unique feature of estrogens is their beneficial safeguard on all privileged healthy cells, while they are capable of recognizing malignant tumor cells and killing them by apoptosis. All previous studies related to women receiving HRT were performed on randomly selected patients, disregarding their risk factors for either insufficient estrogen synthesis or defective estrogen receptor transduction pathways. Recently, the Women"s Health Initiative (WHI) Randomized Trials, which examined the effect of HRT on hysterectomised, crudely estrogen deficient women, found that estrogen treatment resulted in striking decreases in breast cancer development. Moreover, after reanalyzing the data of earlier WHI studies, subsets of women without strong family history of breast cancer, exhibited significantly reduced breast cancer incidence attributable to one armed estrogen treatment. At the same time, women with a family history of breast cancer could have inherited defective estrogen receptor signaling and reactive but insufficient hyperestrogenism. The perspectives for successful HRT will be the separation of postmenopausal patients according to their different inclination to breast cancer risk. The appropriate estrogen dosage will be beneficial against breast cancer and for many other aspects of women"s health as well.

Original languageEnglish
Title of host publicationEndocrine Diseases: Risk Factors, Diagnosis and Management
PublisherNova Science Publishers, Inc.
Number of pages34
ISBN (Print)9781634830645, 9781634825924
Publication statusPublished - Jan 1 2015


ASJC Scopus subject areas

  • Medicine(all)

Cite this

Suba, Z. (2015). Clinical and molecular solutions to the puzzling controversies of hormone replacement therapy. In Endocrine Diseases: Risk Factors, Diagnosis and Management (pp. 59-92). Nova Science Publishers, Inc..