Estrogen replacement therapy and the surgeon

BACKGROUND: The number of patients over the age of 65 years has increased to 33.2 million, with a life expectancy of 76.5 years. With an aging population, the number of surgical procedures is expected to increase as much as 50%. The majority of individuals over 65 years are women. Estrogen replacement therapy is commonly recommended to postmenopausal women for relief of vasomotor symptoms, protection against heart disease, and prevention of osteoporosis. PURPOSE: The purpose of this review is to address estrogen replacement therapy with regard to wound healing, fracture repair, perioperative cardiac morbidity, and thrombosis. DATA SOURCE: Medline Literature review. CONCLUSIONS: There is insufficient evidence to withdraw estrogen replacement therapy at the time of admission for surgery. Patients not receiving estrogen replacement therapy should be offered therapy upon return to ambulatory status. Am J Surg. 2000;179:333-336. (C) 2000 by Excerpta Medica, Inc.