Gynecologic consequences of long-term, unopposed estrogen replacement therapy.
We evaluated the gynecologic risks of unopposed, long-term estrogen use in postmenopausal women. Our medical record review showed that unopposed estrogen users (mean dose, 0.9 mg of conjugated estrogens) had a significantly higher (P less than 0.001) incidence of abnormal vaginal bleeding, curettage, hysterectomy, and endometrial cancer. The ratios of occurrence of these events among users compared with non-users were 7.8, 4.9, 6.6 and 7.7. The prevalence of hysterectomy reached 28.2% of users compared with 5.3% of non-users, and endometrial carcinoma developed in 9.9% of users compared with 1.4% of non-users.
Ettinger
B
B
Department of Internal Medicine, Kaiser Permanente Medical Center, San Francisco, CA 94115.
Golditch
I M
IM
Friedman
G
G
D004107:Dilatation and Curettage / Q000706:statistics & numerical data; D004714:Endometrial Hyperplasia / Q000139:chemically induced; D004967:Estrogens / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007889:Leiomyoma / Q000139:chemically induced; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D010298:Parity; D012307:Risk Factors; D013997:Time Factors; D014591:Uterine Diseases / Q000139:chemically induced* / Q000453:epidemiology; D014592:Uterine Hemorrhage / Q000139:chemically induced; D014594:Uterine Neoplasms / Q000139:chemically induced
D004967:Estrogens