Related Experiment Video
Updated: Oct 4, 2025
An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
Published on: August 13, 2019
The impact of micronized progesterone on cardiovascular events - a systematic review
L M Kaemmle1, A Stadler1, H Janka2
1Medical Faculty of the University of Bern, Bern, Switzerland.
Abstract:
Biologically identical menopausal hormone therapy (MHT) including micronized progesterone (MP) has gained much attention. We aimed to assess the impact of MP in combined MHT on venous and arterial thromboembolism (VTE/ATE) (e.g. deep venous thrombosis/pulmonary embolism, myocardial infarction [MI] and ischemic stroke). Articles were eligible if they provided endpoints regarding cardiovascular events and use of exogenous MP. Literature searches were designed and executed for the databases Medline, Embase, CINAHL, the Cochrane Library, ClinicalTrials.gov and interdisciplinary database Web of Science. Twelve studies consisting of randomized controlled trials (RCTs), case-control studies and prospective or retrospective cohort studies were included, and risk of bias was assessed. Only a minority assessed thromboembolic events as a primary endpoint, showing that in contrast to norpregnane derivatives, primary and recurrent VTE risk was not altered by combining estrogens with MP, which was also true for ischemic stroke risk. Similarly, in placebo-controlled RCTs assessing VTE/ATE as adverse events there were no significant intergroup differences. Studies on MI as a primary endpoint are missing. In conclusion, while available data suggest that MP as a component in combined MHT may have a neutral effect on the vascular system, more RCTs investigating the impact of MP alone or in combined MHT on vascular primary endpoints are needed.
Insights
Micronized progesterone (MP) in menopausal hormone therapy (MHT) appears to have a neutral effect on vascular risks like venous thromboembolism and ischemic stroke. Further research is needed to confirm its impact on cardiovascular events.
Area of Science:
- Reproductive Endocrinology
- Cardiovascular Medicine
- Pharmacology
Background:
- Menopausal hormone therapy (MHT) is widely used for symptom management.
- Micronized progesterone (MP) is a key component in combined MHT formulations.
- Concerns exist regarding the vascular safety of MHT components.
Purpose of the Study:
- To evaluate the impact of micronized progesterone (MP) in combined MHT on venous and arterial thromboembolism (VTE/ATE).
- To assess cardiovascular event risks including deep venous thrombosis, pulmonary embolism, myocardial infarction, and ischemic stroke associated with MP-containing MHT.
Main Methods:
- Comprehensive literature search across multiple databases (Medline, Embase, CINAHL, Cochrane Library, ClinicalTrials.gov, Web of Science).
- Inclusion of 12 studies: randomized controlled trials (RCTs), case-control, prospective, and retrospective cohort studies.
- Risk of bias assessment for included studies.
Main Results:
- Combining estrogens with MP did not alter primary or recurrent VTE risk compared to other progestogens.
- MP-containing MHT showed no significant difference in ischemic stroke risk.
- Placebo-controlled RCTs found no significant intergroup differences in VTE/ATE as adverse events.
- Studies focusing on myocardial infarction as a primary endpoint are lacking.
Conclusions:
- Available data suggest a potentially neutral effect of MP in combined MHT on the vascular system.
- Further high-quality RCTs are necessary to investigate the impact of MP on primary vascular endpoints, both alone and in MHT.
More Related Videos
10:11Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
Published on: October 22, 2014
09:04Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods
Published on: September 10, 2018
Related Concept Videos
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:20Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...