Age Modifies Effects of Estrogen Therapy in Women Without Ovaries

For women aged 50 to 79 years, the effects of conjugated equine estrogens (CEE) do not differ according to bilateral salpingo-oophorectomy (BSO) status; however, age modifies the effect of CEE in women with prior BSO, according to a study published online in the Annals of Internal Medicine.

JoAnn E. Manson, M.D., Dr.P.H., from Brigham and Women's Hospital in Boston, and colleagues examined estrogen therapy outcome by BSO status among 9,939 women aged 50 to 79 years with prior hysterectomy. Participants received CEE or placebo for a median of 7.2 years.

The researchers observed no significant difference in the effects of CEE alone according to BSO status. In women with prior BSO, age modified the effect of CEE. In older women (aged ≥70 years), during the intervention phase, CEE was significantly associated with a net adverse effect (hazard ratio for global index, 1.42); in younger women, the global index was not elevated. Women aged 50 to 59 years with BSO had a treatment-associated decrease in all-cause mortality during cumulative follow-up (hazard ratio, 0.68), while no reduction was seen in older women with BSO. Among women with conserved ovaries, there was no significant association between CEE and outcomes, regardless of age.

"These findings may help inform clinical decision making about the use of estrogen therapy," Manson said in a statement.

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