Progestogens for endometrial protection in combined menopausal hormone therapy: A systematic review.

Menopausal women with an intact uterus choosing estrogens for menopausal symptom relief require a progestogen for endometrial protection. The aim of this systematic review was to evaluate the risks of endometrial hyperplasia resp. malignancy with different progestogens used in combined MHT. Overall, 84 RCTs were included. We found that 1) most studies were done with NETA, followed by MPA, MP and DYD and LNG, 2) most progestogens were only available as oral formulations, 3) the most frequently studied progestogens (oral MP, DYD, MPA, oral and transdermal NETA, transdermal LNG) were assessed in continuously as well as in sequentially combined MHT regimens, 4) FDA endometrial safety criteria were only fulfilled for some progestogen formulations, 5) most studies demonstrated endometrial protection for the progestogen dose and time period examined. However, 6) study quality varied which should be taken into account, when choosing a combined MHT, especially if off-label-use is chosen. Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Citation

Petra Stute, Linus Josef Walker, Astrid Eicher, Elena Pavicic, Argyrios Kolokythas, Susanne Theis, Marc von Gernler, Michael von Wolff, Sabrina Vollrath. Progestogens for endometrial protection in combined menopausal hormone therapy: A systematic review. Best practice & research. Clinical endocrinology & metabolism. 2023 Aug 22:101815

PMID: 37634998

search → result