CONTINUOUS LOW-DOSE COMBINED HORMONE REPLACEMENT THERAPY AND THE RISKOF ENDOMETRIAL CANCER

Hormone replacement therapy (HRT) provides relief of menopausal sympto ms, reverses atrophic urogenital changes, prevents osteoporosis, and p roduces favorable lipoprotein effects. Continuous combined HRT using 2 .5 mg of medroxyprogesterone was designed to increase patient complian ce by eliminating withdrawal bleeding while at the same time retaining the beneficial effects of HRT. There are limited long-term data, howe ver, regarding the safety of continuous combined HRT, Of concern are r eports of endometrial carcinoma arising in women receiving continuous HRT with low-dose progestin. Eight cases of women who developed endome trial carcinoma while on this regimen are presented. The possible incr eased risk of endometrial cancer associated with this regimen may be r elated to inadequate progestin dose, prior use of unopposed estrogen, poor patient compliance, use of less effective progestins, less effici ent reversal of hyperplasia, and the use of progestin continuously. (C ) 1997 Academic Press.