Hormone therapy in women with premature ovarian insufficiency: a systematic review and meta-analysis

• Autor(a) principal: Caroline Reis Gonçalves
• Data de Publicação: 2021
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: http://hdl.handle.net/1843/53176
• topic: premature ovarian insufficiency; hormone therapy; estrogen; progesterone; bone mineral density; meta-analysis; Primary Ovarian Insufficiency; Insuficiência Ovariana Primária; Hormone Replacement Therapy; Terapia de Reposição Hormonal; Estrogens; Estrogênios; Progesterone; Progesterona; Bone Density; Densidade Óssea; Meta-Analysis; Metanálise

The aim of this systematic review and meta-analysis was to evaluate the effects of different hormone therapies (HT) on clinical outcomes in women with premature ovarian insufficiency (POI). We included 31 studies totalizing 4142 participants with POI from diverse etiologies, of whom 2619 received HT and 201 received calcium supplementation, vitamin D, placebo, or no treatment. HT was superior to non-treatment, placebo, calcitriol or calcium to preserve bone mineral density (BMD) in women with POI. HT was associated with up to 80% reduction in the prevalence of hot flushes and with stability or improvement in the quality of life scores. HT induced significant increases in uterine volume and endometrial thickness in women with POI. Overall, the studies had good quality, although some lacked blinding of participants and personnel or had incomplete outcome data. We found moderate to high quality evidence that HT with estrogen and progesterone or progestin is beneficial to women with POI, not only to mitigate menopausal symptoms but also to preserve BMD and avoid uterine atrophy. More studies are needed to reassure the long-term safety of this therapy and to assess its possible impact on the risk of hard outcomes such as bone fractures and cardiovascular events.