Induction of amenorrhea during hormone replacement therapy: Optimal micronized progesterone dose. A multicenter study

Gillet, J Y; André, Gabriel; Faguer, B; Erny, R; Buvat-Herbaut, M.; Domin, Mathilde; Kuhn, Jean Marc; Hédon, B.; Drapier-Faure, E; Barrat, J; Lopès, P.; Magnin, G; Leng, Jiahua; Bruhat, M. A.; Philippe, E

doi:10.1016/0378-5122(94)90060-4

Cited by 39 publications

(20 citation statements)

References 22 publications

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“…In France, MPA or cyproterone acetate are used mainly with oral estradiol, while dydrogesterone, nomegestrol acetate and promegestone are mainly employed with transdermal estradiol [26]. France is also peculiar for the widespread use of micronized natural progesterone (mainly oral), in association with oral or transdermal estradiol [26]; the progesterone dose is 200 mg/day in sequential regimen [40] and 100 mg/day in combined, usually cyclic (25 days/month), regimen [41].…”

Section: Progestin Use In Different Countriesmentioning

confidence: 98%

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Progestins and progesterone in hormone replacement therapy and the risk of breast cancer

Campagnoli

Clavel‐Chapelon

Kaaks

et al. 2005

The Journal of Steroid Biochemistry and Molecular Biology

116

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Controlled studies and most observational studies published over the last 5 years suggest that the addition of synthetic progestins to estrogen in hormone replacement therapy (HRT), particularly in continuous-combined regimen, increases the breast cancer (BC) risk compared to estrogen alone. By contrast, a recent study suggests that the addition of natural progesterone in cyclic regimens does not affect BC risk. This finding is consistent with in vivo data suggesting that progesterone does not have a detrimental effect on breast tissue. The increased BC risk found with the addition of synthetic progestins to estrogen could be due to the regimen and/or the kind of progestin used. Continuous-combined regimen inhibits the sloughing of mammary epithelium that occurs after progesterone withdrawal in a cyclic regimen. More importantly, the progestins used (medroxyprogesterone acetate and 19-Nortestosterone-derivatives) are endowed with some non-progesterone-like effects, which can potentiate the proliferative action of estrogens. Particularly relevant seem to be the metabolic and hepatocellular effects (decreased insulin sensitivity, increased levels and activity of insulin-like growth factor-I, and decreased levels of SHBG), which contrast the opposite effects induced by oral estrogen.

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Section: Progestin Use In Different Countriesmentioning

confidence: 98%

“…Note that the absence of any increase in BC risk in association with natural progesterone HRT regimens reported by the French E3N-EPIC study [26] is consistent with this possibility. In France, in fact, natural progesterone is mainly used in cyclic (sequential and combined) regimens [41].…”

Section: Differences Between the Various Hormone Replacement Therapy mentioning

confidence: 99%

Progestins and progesterone in hormone replacement therapy and the risk of breast cancer

Campagnoli

Clavel‐Chapelon

Kaaks

et al. 2005

The Journal of Steroid Biochemistry and Molecular Biology

116

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“…Endometrial biopsy procedure was described by all but six authors 12,13,16,20,21,25 . The majority either used a pipelle de Cornier 14,15,18,22,24,26 or Novak's curette 14,15,18,22,26 . Others used a needle aspiration (pistolet method) 23 , vabra suction curettage 10,11,15,19 or performed a conventional dilatation and curettage 17,19 .…”

Section: Endometrial Histologymentioning

confidence: 99%

“…Conjugated equine estrogens (CEE) were the most common estrogen component of menopausal hormone therapy (MHT) while others used 17b-estradiol. Estrogen dosage was either high-dose 14,17,19 , standard-dose [10][11][12][13][14][15][16]18,20,[22][23][24][25][26] , low-dose 25 or ultra-low-dose 21 . Estrogens were applied either orally or transdermally.…”

Section: Endometrial Histologymentioning

confidence: 99%

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The impact of micronized progesterone on the endometrium: a systematic review

2016

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Postmenopausal women with an intact uterus using estrogen therapy should receive a progestogen for endometrial protection. International guidelines on menopausal hormone therapy (MHT) do not specify on progestogen type, dosage, route of application and duration of safe use. At the same time, the debate on bioidentical hormones including micronized progesterone increases. Based on a systematic literature review on micronized progesterone for endometrial protection, an international expert panel's recommendations on MHT containing micronized progesterone are as follows: (1) oral micronized progesterone provides endometrial protection if applied sequentially for 12-14 days/month at 200 mg/day for up to 5 years; (2) vaginal micronized progesterone may provide endometrial protection if applied sequentially for at least 10 days/month at 4% (45 mg/day) or every other day at 100 mg/day for up to 3-5 years (off-label use); (3) transdermal micronized progesterone does not provide endometrial protection.

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