Oestrogen and Women’s Health Outcomes: An Umbrella Review
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Abstract
Background: Oestrogen and oestrogen-modulating therapies remain central to women’s health, yet their associations with cancer, cardiovascular outcomes, and fibroid disease continue to be debated. The objective of this umbrella review was to determine: Is oestrogen exposure associated with increased risk of cancer recurrence, ovarian cancer incidence, fibroid regression, or cardiovascular events, and what is the strength of such associations across published systematic reviews and meta-analyses? Material and Methods: A systematic search of PubMed, Embase, and the Cochrane Library up to July 2024 identified 15 eligible systematic reviews and meta-analyses. Study credibility was assessed using AMSTAR-2 and a structured evidence-grading framework. Pooled estimates, heterogeneity statistics, publication bias tests, and exploratory regression analyses were performed. Results: The pooled synthesis did not show an overall statistically significant effect Condition-specific findings emerged: ovarian cancer incidence demonstrated a probable increased risk with systemic hormone exposure, whereas extended endocrine therapy, cardiovascular myocardial infarction, fibroid regression with SERMs, and recurrence in breast or endometrial cancer survivors showed weak or null associations. Funnel plot analyses indicated no significant asymmetry. Linear regression of study-level covariates revealed poor explanatory value. Conclusion: Oestrogen exposure appears condition-specific, with a probable increased risk for ovarian cancer incidence but weak or absent associations for other outcomes.
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Copyright (c) 2025 Vidhyanandhini Paramanandhan, Shobana Ramasamy, Jothikala C, Swathi N, Jamila Hameed
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Vidhyanandhini Paramanandhan, Department of Obstetrics & Gynaecology, Govt Headquarters Hospital, Pollachi, Tamil Nadu, 642001, India.
Department of Obstetrics & Gynaecology, Govt Headquarters Hospital, Pollachi, Tamil Nadu, 642001, India.
Shobana Ramasamy, Department of Obstetrics & Gynaecology, Govt Headquarters Hospital, Pollachi, Tamil Nadu, 642001, India.
Department of Obstetrics & Gynaecology, Govt Headquarters Hospital, Pollachi, Tamil Nadu, 642001, India.
Jothikala C, Department of Obstetrics & Gynaecology, Govt Headquarters Hospital, Pollachi, Tamil Nadu, 642001, India.
Department of Obstetrics & Gynaecology, Govt Headquarters Hospital, Pollachi, Tamil Nadu, 642001, India.
Swathi N, Data Analyst & Statistician, Department of Medical Research, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India
Data Analyst & Statistician, Department of Medical Research, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India
Jamila Hameed, Research Mentor, Emeritus professor of Obstetrics & Gynecology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India
Research Mentor, Emeritus professor of Obstetrics & Gynecology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India
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