The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned?

This is a major study which has been ongoing for many years, from the Mayo Clinic. Their conclusions show the safety and benefits from HRT given after the menopause, and no increase in blood clots. This is just further evidence of what I have been saying for many years.

Menopause. 2019 Sep;26(9):1071-1084. doi: 10.1097/GME.0000000000001326.

The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned?

Miller VM1, Naftolin F2, Asthana S3, Black DM4, Brinton EA5, Budoff MJ6, Cedars MI7, Dowling NM8, Gleason CE9, Hodis HN10, Jayachandran M11, Kantarci K12, Lobo RA13, Manson JE14, Pal L15, Santoro NF16, Taylor HS15, Harman SM17.

Author information

1Departments of Surgery and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN.2Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY.3Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, University of Wisconsin School of Medicine and Public Health and the Geriatric Research, Madison, WI.4Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA.5Utah Lipid Center, Salt Lake City, UT.6Department of Medicine, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles, Torrance, CA.7Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA.8Departments of Acute and Chronic Care, Epidemiology and Biostatistics, George Washington University School of Nursing and Milken Institute School of Public Health, Washington, DC.9Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health and the William S. Middleton Memorial VA, Geriatric Research, Education and Clinical Center, Madison, WI.10Atherosclerosis Research Unit, University of Southern California, Los Angeles, CA.11Department of Physiology and Biomedical Engineering, Division of Nephrology and Hypertension, Division of Hematology Research, Mayo Clinic, Rochester, MN.12Department of Radiology, Mayo Clinic, Rochester, MN.13Department of Obstetrics and Gynecology, Columbia University, New York, NY.14Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.15Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT.16Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO.17Phoenix Veterans Administration Health Care System, Phoenix, AZ.



The Kronos Early Estrogen Prevention Study (KEEPS) was designed to address gaps in understanding the effects of timely menopausal hormone treatments (HT) on cardiovascular health and other effects of menopause after the premature termination of the Women’s Health Initiative.


The KEEPS was a randomized, double-blinded, placebo-controlled trial to test the hypothesis that initiation of HT (oral conjugated equine estrogens [o-CEE] or transdermal 17β-estradiol [t-E2]) in healthy, recently postmenopausal women (n = 727) would slow the progression of atherosclerosis as measured by changes in carotid artery intima-media thickness (CIMT).


After 4 years, neither HT affected the rate of increase in CIMT. There was a trend for reduced accumulation of coronary artery calcium with o-CEE. There were no severe adverse effects, including venous thrombosis. Several ancillary studies demonstrated a positive effect on mood with o-CEE, and reduced hot flashes, improved sleep, and maintenance of bone mineral density with both treatments. Sexual function improved with t-E2. There were no significant effects of either treatment on cognition, breast pain, or skin wrinkling. Variants of genes associated with estrogen metabolism influenced the age of menopause and variability in effects of the HT on CIMT. Platelet activation associated with the development of white matter hyperintensities in the brain.


KEEPS and its ancillary studies have supported the value and safety of the use of HT in recently postmenopausal women and provide a perspective for future research to optimize HT and health of postmenopausal women. The KEEPS continuation study continues to pursue these issues.

About Dr Colin Holloway

Gp interested in natural hormone treatment for men and women of all ages

Posted on December 16, 2019, in Uncategorized. Bookmark the permalink. Comments Off on The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned?.

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