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The role and use of progestogens
M I Whitehead1, T C Hillard, D Crook
1Department of Obstetrics and Gynecology, Kings College School of Medicine and Dentistry, Denmark Hill, London, England.
Obstetrics and Gynecology
|April 1, 1990
Summary
Estrogen therapy increases endometrial cancer risk in postmenopausal women. While progestogens reduce this risk, continuous combined therapy has limited data and potential side effects, warranting caution.
Area of Science:
- Reproductive endocrinology
- Menopause management
- Oncology
Background:
- Hormone replacement therapy (HRT) is used for menopausal symptoms.
- Estrogen therapy alone increases endometrial cancer risk.
- Progestogens are added to mitigate this risk.
Purpose of the Study:
- To review data on estrogen and progestogen effects in postmenopausal women.
- To evaluate the safety and efficacy of continuous combined therapy.
- To assess the impact on endometrial, physical, psychological, and lipid status.
Main Methods:
- Review of epidemiologic, histologic, and biochemical data.
- Analysis of studies on unopposed estrogen, cyclic progestogen, and continuous combined therapy.
- Evaluation of side effects, bleeding patterns, and lipid profiles.
Main Results:
- Unopposed estrogen increases endometrial cancer risk long-term.
- Cyclic progestogens reduce risk, but optimal levels are unclear.
- Continuous combined therapy shows efficacy but has common side effects and limited lipid data.
Conclusions:
- Continuous combined therapy's long-term safety and lipid effects require more research.
- Current enthusiasm for continuous combined therapy may be premature.
- Caution is advised until more conclusive data are available.