GYNECOLOGIC COMPLICATIONS OF CYCLIC ESTROGEN-PROGESTIN THERAPY

We evaluated the long-term gynecologic risks of postmenopausal estroge n therapy in conjunction with cyclic, monthly progestin (progestin-est rogen 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 r ate of dilation and curettage (RR, 1.5; CI, 0.7-3.3) among women recei ving PERT. However, rates of endometrial hyperplasia and hysterectomy were similarly low in both groups. PERT apparently protects women agai nst these serious gynecologic consequences previously seen in women ta king unopposed estrogen.