Cardiovascular Health

• Estradiol-based hormone therapy may have a better safety profile for venous thromboembolism (VTE), cardiovascular outcomes compared to conjugated equine estrogens (CEE) [1]

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Brain Health

• Estradiol-based hormone therapy may have a better safety profile for cognitive protection compared to conjugated equine estrogens (CEE) [1]

• Hormone therapy may lower the risk of dementia [6]

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Bone Health

• Estradiol-based hormone therapy may have a better safety profile for bone health compared to conjugated equine estrogens (CEE) [1]

• Hormonal and lifestyle factors play key roles in bone health.  Higher estradiol levels, physical activity, body mass index (BMI), and vitamin D intake positively correlate with bone mineral density [3]

• Higher estradiol levels are positively associated with better lumbar bone mineral density [4]

• A circulating estradiol level of at least 60 pg/ml is required to prevent postmenopausal bone loss [5]

• Estrogen-progestin therapy showed slightly better bone mineral density improvements than alendronate [7]

• Transdermal estrogen is effective in protecting bone structure and preventing bone loss in postmenopausal women [8]

• Estradiol gel is effective at preventing bone loss [9]

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Cancer Risk

• Estradiol-only hormone therapy may lower the risk of dying from breast cancer in women undergoing postmenopausal treatment [2]

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References

1. Review of menopausal hormone therapy with estradiol and progesterone versus other estrogens and progestins. https://pubmed.ncbi.nlm.nih.gov/36075250/. 2022 Nov.

2. Reduced risk of breast cancer mortality in women using postmenopausal hormone therapy: a Finnish nationwide comparative study.  https://pubmed.ncbi.nlm.nih.gov/27465718/. 2016 Nov.

3. Levels of serum estradiol and lifestyle factors related with bone mineral density in premenopausal Mexican women: a cross-sectional analysis. https://pubmed.ncbi.nlm.nih.gov/27756278/. 2016 Oct 19.

4. Association between serum estradiol level, sex hormone binding globulin level, and bone mineral density in middle-aged postmenopausal women. https://pubmed.ncbi.nlm.nih.gov/34717706/. 2021 Oct 30.

5. Minimal levels of serum estradiol prevent postmenopausal bone loss. https://pubmed.ncbi.nlm.nih.gov/1458336/. 1992 Nov.

6. A Comparison of Bone-Targeted Exercise With and Without Antiresorptive Bone Medication to Reduce Indices of Fracture Risk in Postmenopausal Women With Low Bone Mass: The MEDEX-OP Randomized Controlled Trial. https://pubmed.ncbi.nlm.nih.gov/34033146/. 2021 May 25.

7. Prevention of bone loss with alendronate in postmenopausal women under 60 years of age. Early Postmenopausal Intervention Cohort Study Group. https://pubmed.ncbi.nlm.nih.gov/9443925/. 1998 Feb 19.

8. The Effects of Transdermal Estrogen Delivery on Bone Mineral Density in Postmenopausal Women: A Meta-analysis. https://pubmed.ncbi.nlm.nih.gov/28496491/. 2017 Winter

9. A clinical trial of 3 doses of transdermal 17beta-estradiol for preventing postmenopausal bone loss: a preliminary study. https://pubmed.ncbi.nlm.nih.gov/17524997/. 2007 May.

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