This paper is only available as a PDF. To read, Please Download here.
Abstract
We evaluated the long-term gynecologic risks of postmenopausal estrogen therapy in
conjunction with cyclic, monthly progestin (progestin-estrogen replacement therapy,
or PERT). Our medical record review showed that incidence of abnormal vaginal bleeding
necessitating gynecologic procedures for evaluation was significantly higher (RR,
3.1; 95% CI, 2.1–4.5), as was the rate of endometrial biopsy (RR, 3.4; 95% CI, 2.3–5.1),
among women receiving PERT than among women not receiving hormone therapy. We also
identified a non-significant trend toward a higher rate of dilation and curettage
(RR, 1.5; CI, 0.7-3.3) among women receiving PERT. However, rates of endometrial hyperplasia
and hysterectomy were similarly low in both groups. PERT apparently protects women
against these serious gynecologic consequences previously seen in women taking unopposed
estrogen.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Gynecologic consequences of long-term unopposed estrogen replacement therapy.Maturitas. 1988; 10: 271-282
- Endometrial cancer and patterns of use of oestrogen replacement therapy: a cohort study.Br J Cancer. 1989; 59: 445-447
- Endometrial hyperplasia in women on cyclic or continuous estrogen regimens.Fertil Steril. 1982; 37: 79-82
- The effects of oestrogens and progestogens on the postmenopausal endometrium.Maturitas. 1978; 1: 87-98
- Management of postmenopausal bleeding to prevent endometrial cancer.Maturitas. 1978; 1: 99-106
- Risk of endometrial cancer after treatment with oestrogens along or in conjunction with progestogens: results of a prospective study.Br Med J. 1989; 298: 147-151
- Epidemiologic research: principles and quantitative methods.Lifetime Learning Publications, Belmont, California1982
- Treatment of leiomyomata uteri with short-term leuprolide followed by leuprolide plus estrogen-progestin replacement therapy for 2 years: a pilot study.Fertil Steril. 1989; 51: 526-528
- The modifying effect of progestogen on the response of the post-menopausal endometrium to exogenous oestrogens.Postgrad Med J. 1978; 54: 59-64
- A randomized, double-blind trial of a gonadotropin releasing-hormone agonist (leuprolide) with or without medroxyprogesterone acetate in the treatment of leiomyomata uteri.Fertil Steril. 1988; 49: 404-409
- Past and present preferred prescribing practices of hormone replacement therapy among Los Angeles gynecologists: possible implications for public health.Am J Public Health. 1988; 78: 516-519
- Evaluation of a continuous combined low-dose regimen of estrogen-progestin for treatment of the menopausal patient.Am J Obstet Gynecol. 1990; 162: 1534-1542
- Endometrial histology and bleeding patterns after 8 years of continuous combined estrogen and progestin therapy in postmenopausal women.Obstet Gynecol. 1991; 78: 1008-1010
Article info
Publication history
Accepted:
February 9,
1993
Received in revised form:
January 16,
1993
Received:
September 29,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.
