Is it safe to prescribe hormonal contraception and replacement therapy to patients with premalignant and malignant uterine cervices?
The levels of estrogen and progesterone receptors in normal and abnormal uterine cervices were determined. The study group consisted of 14 patients with cervical intraepithelial neoplasia (CIN III) and 7 patients with invasive carcinoma of the cervix (stage IB-IIA). The control group included 23 patients who underwent total abdominal hysterectomy for menorrhagia, leiomyoma, etc. The concentration of total estrogen receptors in premalignant and malignant cervices did not differ from the patients with benign conditions of the cervix. The concentration of progesterone receptors was significantly higher in the nonaffected cervices than in the patients with preinvasive and invasive carcinoma of the cervix (P less than 0.05). We have shown that estrogen receptor concentrations do not differ between women with normal and abnormal uterine cervices. Therefore, we feel that the contraceptive pill is not contraindicated in women who have been treated for CIN III. We also maintain that hormone replacement therapy should be given, when indicated, to women who have been castrated following surgery and/or radiotherapy for invasive carcinoma of the cervix.
Sadan
O
O
Department of Obstetrics and Gynecology, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Frohlich
E P
EP
Driscoll
J A
JA
Apostoleris
A
A
Savage
N
N
Zakut
H
H
Frohlich
R P
RP
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000032:analysis; D003276:Contraceptives, Oral / Q000009:adverse effects; D004967:Estrogens / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D012016:Reference Values; D002578:Uterine Cervical Dysplasia / Q000032:analysis / Q000473:pathology* / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000032:analysis / Q000473:pathology* / Q000601:surgery
D003276:Contraceptives, Oral; D004967:Estrogens; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone