The Mature Woman
Menopause may be identified by which of the following?
a. The point in time 1 year after cessation of menses
b. The time when menstruation permanently stops due to loss of ovarian function
c. The state associated with physical symptoms and with metabolic and structural changes related to declining estrogen levels
Regarding the findings from the large observational Nurses’ Health Study (Stampfer, 1985), all of the following are correct EXCEPT:
a. It identified a significant reduction in heart disease among postmenopausal hormone users.
b. It suggested at least a doubling of cerebrovascular disease among postmenopausal hormone users.
c. Its findings likely were confounded by timing of the initiation of postmenopausal hormone therapy.
d. It was likely biased by including participants that were not representative of the U.S. postmenopausal population.
The Writing Group for the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial (1995) reported which of the following regarding women receiving placebo compared with those receiving hormones?
a. Fibrinogen levels were increased.
b. Cardiac morbidity declined by 50 percent.
c. Low-density lipid levels declined.
d. High-density lipid levels increased.
Which of the following is correct regarding the Heart and Estrogen/Progestin Replacement Study (HERS) and HERS II.
a. They included healthy women without preexisting heart disease.
b. They showed that estrogen was a useful medication for secondary prevention of cardiac disease progression.
c. They showed (at 1 year) an increased rate of myocardial infarction in women who received conjugated equine estrogen and continuous medroxyprogesterone acetate.
d. They showed (at 4 years) a sustained increased risk of myocardial infarction in women receiving combined hormone therapy.
A 56-year-old woman has been amenorrheic for 4 years and asks whether hormone therapy will lead to heart attack. You explain that results from the Women’s Health Initiative (WHI) suggest ...