Are progestins really necessary as part of a combined HRT regimen?

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  • Author(s): Sturdee DW;Sturdee DW
  • Source:
    Climacteric : the journal of the International Menopause Society [Climacteric] 2013 Aug; Vol. 16 Suppl 1, pp. 79-84. Date of Electronic Publication: 2013 Jun 03.
  • Publication Type:
    Journal Article; Review
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 9810959 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-0804 (Electronic) Linking ISSN: 13697137 NLM ISO Abbreviation: Climacteric Subsets: MEDLINE
    • Publication Information:
      Publication: London : Informa Healthcare
      Original Publication: New York : Parthenon Pub., c1998-
    • Subject Terms:
      Menopause*; Estrogen Replacement Therapy/*methods ; Progestins/*administration & dosage; Breast Neoplasms/chemically induced ; Endometrial Hyperplasia ; Endometrial Neoplasms/chemically induced ; Endometrial Neoplasms/prevention & control ; Estrogen Replacement Therapy/adverse effects ; Female ; Humans ; Progestins/adverse effects ; Risk Factors ; Women's Health
    • Abstract:
      For many years it has been perceived wisdom that hormone replacement therapy for women with a uterus should include a progestin to prevent the proliferative effects of estrogen on the endometrium and endometrial cancer. But, with the reports from the Women's Health Initiative (WHI) and Million Women Study indicating that such regimens are associated with an increased risk of breast cancer, whereas unopposed estrogen may not increase this risk, or even reduce it, it is pertinent to reassess the merits of adding a progestin. In addition, the suggestion from the WHI that the effects of estrogen and progestins are a 'class effect' are clearly inaccurate, as there is particular evidence from the French E3N cohort studies of differential effects of progestins, with progesterone and dydrogesterone additions showing no increase in risk of breast cancer. The data are presented but an answer to the posed question remains unclear and as usual dependent on the circumstances and views of each individual woman and her medical adviser.
    • Accession Number:
      0 (Progestins)
    • Publication Date:
      Date Created: 20130509 Date Completed: 20140224 Latest Revision: 20130715
    • Publication Date:
      20240829
    • Accession Number:
      10.3109/13697137.2013.803311
    • Accession Number:
      23651281