94332643 Assessment of less than monthly progestin therapy in postmenopausal women given estrogen replacement

Williams, Daniel B.; Voigt, Barbara; Fu, Yanpeng; Schoenfeld, M. J.; Judd, Howard L.

doi:10.1016/0378-5122(95)91217-3

Cited by 6 publications

(6 citation statements)

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“…Such endometrial sloughing may also provide an explanation for the observations made some 10 years ago that CEE at 0.625 mg/day did not produce hyperplasia if 10 mg of MPA was given for 14 days every 3 months (Ettinger et al, 1994;Williams et al, 1994). Hyperplasia did occur in a further trial in which estradiol was given at 2 mg/day for 68 days, followed by norethisterone at 1 mg/day for 10 days and finally estradiol at 1 mg/day for 6 days (Cerin et al, 1996).…”

Section: Menopausal Hormone Therapymentioning

confidence: 87%

Prevention of cancers of the breast, endometrium and ovary

2004

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A central epidemiological feature of cancers of the breast, endometrium and ovary is the sharp slowing down in their rate of increase with age around the time of menopause. The incidence of these tumors by the age of 70 years would be between fourfold and eightfold increased if the rapid increase with age seen in young women continued into old age. These phenomena can be explained by the different effects of ovarian hormones on cell division rates in the relevant tissues. Models of these effects provide a plausible explanation of most of the known epidemiology of each of the cancers, including the increase in breast cancer risk from menopausal estrogen-progestin therapy. Some recent epidemiological findings in endometrial and ovarian cancer suggest new avenues for possible chemoprevention of these cancers.

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Section: Menopausal Hormone Therapymentioning

confidence: 87%

Prevention of cancers of the breast, endometrium and ovary

2004

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“…If these routes of administration are unacceptable to a woman, then giving progestins for 13 days every 3-4 months may provide satisfactory protection of the endometrium with proportionally less effect on the breast than monthly administration. Two clinical trials of administering 10 mg MPA/day for 14 days every 3 months have been published in which the dose of conjugated estrogen was 0.625 mg/day (Ettinger et al 1994, Williams et al 1994. Both studies suggest that this approach may be satisfactory with such low-dose estrogen.…”

Section: Required Progestinmentioning

confidence: 99%

Hormonal contraception and chemoprevention of female cancers.

Pike¹,

Spicer²

2000

Endocrine-Related Cancer

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Oral contraceptive (OC) use significantly reduces the risk of endometrial and ovarian cancer, has only a minimal effect on breast cancer, but may increase the risk of cervical cancer. These effects can be readily explained in terms of the effects of OCs on cell proliferation in these tissues. This analysis suggests how a hormonal contraceptive based on a GnRH agonist plus low-dose add-back sex steroids could be made that would greatly reduce lifetime risk of breast and ovarian cancer. Such a hormonal contraceptive is also likely to significantly reduce the lifetime risk of cervical cancer. It is also likely to reduce the risk of endometrial cancer, although not to the same extent as OCs.

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“…For combined therapy (estrogen and cyclic or continuous progestin), OR for myometrial invasion or high-grade tumors were not significantly different from hormone nonusers. For women experiencing undesired side effects of progestin treatment (fatigue, headache, edema, mood disorders) long cycle hormone replacement therapy has been recommended, where unopposed estrogens are given for 3-6 months before a progestin is added to induce endometrial transformation and bleeding [16]. In a randomized trial in Scandinavia, Bjarnason et al [17] compared hormone replacement therapy with a progestin administered for 10 days during 12-week or 4-week cycles of estrogen administration.…”

Section: Impact Of Hormone Replacement Therapy On the Tumorigenesis Omentioning

confidence: 99%

Hormone Replacement Therapy and Endometrial Cancer

et al. 2004

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Postmenopausal hormone replacement therapy (HRT) using unopposed estrogens significantly increases endometrial cancer risk and should not be used in non-hysterectomized women. Even low-potency estrogens (oral estriol) or low-dose unopposed estrogens significantly enhance the risk to develop endometrial cancer. This risk is markedly reduced, when in addition to estrogens, progestins are administered for at least 10 days (better 14 days) per month. In some studies, a normalization of endometrial cancer risk to that of women receiving no HRT was only found when a continuous combined estrogen/progestin replacement was used. The use of progestins for less than 10 days per month and long-cycle regimens, where a progestin is added only every 3 months cannot be recommended. For women needing HRT, estrogen dose should be selected as low as possible and reassessment of the need of HRT should be performed annually.

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94332643 Assessment of less than monthly progestin therapy in postmenopausal women given estrogen replacement

Cited by 6 publications

References 0 publications

Prevention of cancers of the breast, endometrium and ovary

Prevention of cancers of the breast, endometrium and ovary

Hormonal contraception and chemoprevention of female cancers.

Hormone Replacement Therapy and Endometrial Cancer

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