Gynecologic complications of cyclic estrogen progestin therapy |
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Authors: | Bruce Ettinger Joseph V Selby John T Citron Vivian M Ettinger Danya Zhang |
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Institution: | a Kaiser Foundation Research Institute, Oakland, USA b Department of Medicine, Kaiser Permanente Medical Center, Walnut Creek, USA c Kaiser Foundation Research Institute, Oakland, California, USA |
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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. |
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Keywords: | Endometrial hyperplasia Endometrium Estrogens Menopause Progestational hormones Uterine neoplasms |
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