Sex Hormones and Related Compounds, Including Hormonal Contraceptives

The 2014 document provided a comprehensive overview of the effects and risks associated with sex hormones and related compounds. It highlighted that in utero exposure to diethylstilbestrol increased the risk of gynecological conditions in 4653 exposed women compared to 1927 controls. Estradiol valerate was found to be more favorable than ethinylestradiol/levonorgestrel for metabolic and hemostatic parameters in 58 healthy women, and low-dose transdermal estradiol gel was effective for 209 Japanese women with estrogen deficiency symptoms. Early HRT post-menopause could reduce mortality and heart issues without increasing breast cancer or stroke risks. Hormonal contraceptives' risks vary, with newer contraceptives potentially having a lower venous thromboembolism risk, and progestogen-only contraceptives being safe for those with thromboembolism history. The document also discussed the benefits and risks of various hormonal therapies, including letrozole as a preferred aromatase inhibitor, despite its side effects, as shown in a study of 33 women. Bazedoxifene and lasofoxifene were evaluated for postmenopausal osteoporosis, with lasofoxifene increasing endometrial thickness and polyps in an 8,556-woman study. Other findings included the potential risks of tamoxifen, drospirenone, depot medroxyprogesterone acetate, nomegestrol acetate, mifepristone, anabolic steroids, and danazol. Testosterone therapy's cardiovascular risks were noted, including thrombotic events in six hypogonadal men, and the TIMES 2 study of 220 men showed testosterone reduced insulin resistance and LDL cholesterol. Testosterone was also linked to reversible azoospermia. Finasteride for alopecia in women showed no benefit over placebo in controlled trials and was associated with rare adverse effects. Flutamide was linked to hepatotoxicity, especially in women using it for acne or hirsutism.