PROGESTINS AND ENDOMETRIAL SAFETY - THE FRENCH POINT-OF-VIEW

Numerous progestogens are available in Europe for hormone replacement therapy. Provided that an appropriate dose is given for at least 10 da ys each cycle, the addition of any of them eliminates the excess risk of endometrial cancer due to unopposed estrogen therapy. However, andr ogenic progestogens induce unfavorable metabolic alterations and may r educe the cardiovascular benefits of estrogen therapy. Although there is a lack of epidemiological data on the influence on vascular risk of adding an androgenic progestogen to estrogens, it appears preferable to use nonandrogenic progestogens. Of these, micronized progesterone, dydrogesterone, pregnane and norpregnane derivatives constitute the be st choice for any nonhysterectomized women.