Newer Progestogens

  • Göran Samsioe
Part of the Medical Science Symposia Series book series (MSSS, volume 13)


Sweats and hot flushes, the most abundant symptoms of the menopause, are effectively treated by estrogens, a fact that has been known for decades. However, estrogen treatment was fairly uncommon prior to 1960 when it started to increase, especially in the United States. Estrogens were almost always given as a monotherapy. When a sufficient number of women had used this estrogen monotherapy for several years, observational studies suggested in 1975 that there might be association between estrogen monotherapy and the occurrence of endometrial cancer. Several experimental and epidemiological studies have later confirmed this relationship. At this time it was also found that the estrogen-associated increase in endometrial cancer commonly occurred via endometrial hyperplasia. Several studies in the late seventies indicated that progestogen comedication would almost abolish the risk of hyperplasia of the endometrium when given in sufficient dosage over a period of at least ten days. All commercially available progestogens seem to confer endometrial protection against endometrial hyperplasia. This concept was also believed to protect from the estrogen-induced endometrial cancer, a fact that is confirmed by several studies today, although endometrial cancer may still occur also in women using combined hormone replacement therapy (HRT) as all cancers are not driven by the hormonal milieu. Thus doses of progestogens often used in sequential therapy such as medroxyprogesterone acetate 5–10 mg, norethisterone acetate 1 mg, levonorgestrel 75 μg, desogestrel 150 μg, dydrogesterone 10 mg, cyproterone acetate 1 mg, and natural progesterone 200–300 mg seem not to interfere with the estrogen-induced overall beneficial lipid changes.


Estrogen Receptor Estrogen Replacement Therapy Neointimal Formation Estrogen Receptor Expression Vascular Smooth Muscle Cell Proliferation 
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© Kluwer Academic Publishers and Fondazione Giovanni Lorenzini 1999

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  • Göran Samsioe

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