Protecting the endometrium - Opposing the hyperplasia/malignancy potentialof ERT

Many trials have examined the clinical and histologic effects of various ho rmone replacement therapy combinations With the objective of minimizing the incidence of hyperplasia and the potential for subsequent development of a denocarcinoma. Reviewing the results of these trials, it appears that high- dose, long-term progestogen therapy is effective in protecting the endometr ium, with duration having a greater impact than dose. Among women given 0.6 25 mg conjugated equine estrogen (CEE), sequential regimens should include 5 or 10 mg medroxyprogesterone acetate (MPA) or 200 mg micronized progester one for 12 days or more Continuous combined regimens require 2.5-5 mg MPA. With women who are taking 1.25 mg CEE the data are less clear, but recommen dations include administration with 10 mg MPA for 12-14 days or 5 mg MPA co ntinuous combined therapy.