Protecting the endometrium. Opposing the hyperplasia/malignancy potential of ERT.
Many trials have examined the clinical and histologic effects of various hormone replacement therapy combinations with the objective of minimizing the incidence of hyperplasia and the potential for subsequent development of adenocarcinoma. Reviewing the results of these trials, it appears that high-dose, long-term progestogen therapy is effective in protecting the endometrium, with duration having a greater impact than dose. Among women given 0.625 mg conjugated equine estrogen (CEE), sequential regimens should include 5 or 10 mg medroxyprogesterone acetate (MPA) or 200 mg micronized progesterone for 12 days or more. Continuous combined regimens require 2.5-5 mg MPA. With women who are taking 1.25 mg CEE the data are less clear, but recommendations include administration with 10 mg MPA for 12-14 days or 5 mg MPA continuous combined therapy.
Gibbons
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Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 601 Colley Avenue, Suite 229, Norfolk, VA 23507-1627, USA.
Thorneycroft
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IH
D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004714:Endometrial Hyperplasia / Q000139:chemically induced* / Q000517:prevention & control; D016889:Endometrial Neoplasms / Q000139:chemically induced* / Q000517:prevention & control; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D011374:Progesterone / Q000008:administration & dosage / Q000494:pharmacology*; D045167:Progesterone Congeners / Q000008:administration & dosage / Q000494:pharmacology*; D012307:Risk Factors
D045167:Progesterone Congeners; D011374:Progesterone; D017258:Medroxyprogesterone Acetate