Menopause Perhaps the most familiar type of steroid hormone therapy is estrogen replacement therapy (ERT) for women whose ovaries have been removed surgically or women who have symptoms related to menopause. The first estrogen drug, under the trade name Premarin, was available in injectable form in 1942. The pill form gained popularity as the ‘‘medicalization’’ of menopause increased. The hormone was derived from the urine of pregnant mares. When the relationship between osteoporosis, hip fracture, and low estrogen levels was recognized, ERT was recommended for all women. The ‘‘baby-boomer’’ generation (those born between 1946 and 1964) was particularly receptive to ERT promotion, and by the end of the century one third of postmenopausal women in the U.S. were taking some kind of hormone replacement therapy. In 1975, research indicated that unopposed estrogen raised the rate of endometrial cancers. Progesterone was added to estrogen, and the treatment became known as HRT (hormone replacement therapy). By the year 2000, esterified estrogens, synthetic estrogen from plant sources, and combinations with testosterone and progestins were prescribed as pills, transdermal skin patches, or intravaginal applicators. Studies early in the twenty-first century, however, determined that although these drugs were safer, they did not provide sufficient protection against osteoporosis or cardiovascular disease in women to warrant the risks of therapy.
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