Endometrial Cancer and Estrogen Use. Report of a Large Case Control Study

Antunes, Carlos; Stolley, Paul D.; Rosenshein, Neil B.; Davies, Joan L.; Tonascia, James; Brown, Charles; Burnett, Lonnie S.; Rutledge, Ann; Pokempner, Merle; García, Rafael Castañeda

doi:10.1097/00006254-197905000-00026

Cited by 17 publications

(21 citation statements)

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“…9 Combined treatment was investigated, because, in some instances, administration of ERT can induce endometrial hyperplasia and carcinoma. 10 Concern about this effect prompted administration of progestins together with estrogen to reduce such risks in postmenopausal women who had not undergone hysterectomy. 11 Medroxyprogesterone acetate (MPA) is commonly used as a progestin combined with estrogen, as in the HERS.…”

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confidence: 99%

Effect of Medroxyprogesterone Acetate on Endothelium-Dependent Vasodilation in Postmenopausal Women Receiving Estrogen

et al. 2001

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Background-Estrogen increases endothelium-dependent vasodilation in postmenopausal women. However, use of progestins in combination with estrogen may counter beneficial effects of estrogen on endothelium. We investigated the effect of medroxyprogesterone acetate (MPA) on estrogen-induced increase in endothelium-dependent vasodilation in postmenopausal women. Methods and Results-Postmenopausal women were treated daily with conjugated equine estrogen (CEE) 0.625 mg (nϭ14), CEE 0.625 mg and MPA 2.5 mg (nϭ15) or CEE 0.625 mg and MPA 5.0 mg (nϭ16) for 3 months. Plasma lipids and hormones were measured before and after treatment. Vasodilatory responses of the brachial artery were evaluated by measuring flow-mediated vasodilation (FMD) and nitroglycerin-induced vasodilation by use of high-resolution ultrasonography. Susceptibility of LDL to oxidation was analyzed by incubation with CuSO 4 while kinetics of conjugated diene formation was monitored. Plasma total and LDL cholesterol concentrations were decreased significantly in all groups. CEE increased FMD significantly, from 4.5Ϯ1.7% to 8.5Ϯ2.8% (PϽ0.001). Addition of MPA reversed this effect in a concentration-dependent manner (for MPA 2.5 mg, from 5.0Ϯ3.2% to 6.2Ϯ3.1%; for MPA 5.0 mg, from 4.9Ϯ3.4% to 3.6Ϯ3.7%; PϭNS for each). No treatment significantly altered nitroglycerin-induced dilation. Lag time for conjugated diene formation was prolonged significantly in all groups, and the oxidation rate was significantly reduced. Conclusions-Concurrent MPA administration may offset favorable effects of estrogen on endothelial function in postmenopausal women. Because MPA did not diminish LDL-lowering and antioxidant effects of estrogen, MPA-induced inhibition of endothelium-dependent vasodilation may be independent of changes in oxidative susceptibility and plasma concentration of LDL.

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confidence: 99%

Effect of Medroxyprogesterone Acetate on Endothelium-Dependent Vasodilation in Postmenopausal Women Receiving Estrogen

et al. 2001

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“…Eine alleinige Östrogentherapie bedingt eine bis zu 15-fache Steigerung des relativen Risikos für die Entwicklung eines Endometriumkarzinoms [49][50][51][52] . Auch nach Beendigung einer Östrogentherapie bleibt ein erhöhtes Risiko über 15 Jahre bestehen [52,53] .…”

Section: Endometriumkarzinomunclassified

Nutzen und Risiko der Hormonersatztherapie – ein Update

Schmidt

2006

Gynäkol Geburtshilfliche Rundsch

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Die Hormonersatztherapie (HRT) mit Östrogenen und Gestagenen wird seit mehr als 40 Jahren zur Behandlung klimakterischer Beschwerden eingesetzt. Die HRT mit Östrogenen oder als kombinierte Östrogen-Gestagen-Therapie kann als wirkungsvolle Behandlung von vasovegetativen Symptomen sowie von Beschwerden der urogenitalen Atrophie angesehen werden. In den letzten Jahren sind hinsichtlich der Risiken der HRT vermehrt Bedenken erhoben worden, die zu einem Sinneswandel bei Ärzten und Patientinnen geführt haben. Auslöser für diesen Sinneswandel waren im Wesentlichen drei grosse internationale Studien: die Heart and Estrogen/Progestin Replacement Study, die Women’s Health Initiative Study und die One Million Women Study. Ziel dieser Arbeit ist es, den aktuellen Stand der teils kontrovers geführten Diskussion zu Nutzen und Risiken der HRT aufzuzeigen.

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“…ERT also reduces rates of bone resorption, thereby reversing rates of osteoporosis and osteoporotic fractures, by as much as 60% [29,38,39]. Unfortunately, ERT exerts a dose-and duration-of-usedependent proliferative effect on the uterine lining and several studies have demonstrated an increased rate of endometrial cancer associated with ERT [29,37,[40][41][42]. Results from the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial, however demonstrated that addition of cyclic micronized progesterone to ERT negated the risk of endometrial hyperplasia (as measured by baseline and annual endometrial aspiration biopsy) without adversely affecting the favorable impact of ERT on the cholesterol profile [34].…”

Section: General Populationmentioning

confidence: 99%