Strategies to reduce the incidence of endometrial cancer in postmenopausal women

Endometrial Cancer: Hormonal Factors, the Perimenopausal “Window of Risk,” and Isoflavones

“…Gelfand and Ferenczy (75) found that the administration of 5 mg MPA for 11 d with 0.635 mg CEE was associated with EH in 4.4% in 45 women at 6 months. Subsequently, a review of nine studies on a total of 66 cases of EC occurring during combined HRT concluded that a minimum daily dose of 10 mg MPA or 2.5 mg norethindrone acetate was required for 12-14 d of the cycle for full protection from EH (76). In a large Swedish case control study, however, an increased risk of EC was found [odds ratio (OR), 1.6; CI, 1.1-2.4] with the administration of fewer than 16 d of a progestin (49).…”

Bleeding patterns during continuous estradiol with different sequential progestogens therapy

“…10 The addition of a progestogen reduces this risk but may cause irregular bleeding and spotting, which in turn can reduce adherence to therapy. [11][12][13][14] Because natural progesterone is poorly absorbed and rapidly metabolized after oral administration, synthetic derivatives of progesterone, characterized by high oral bioavailability, are generally used in combination with estrogen in HT.…”

Diagnosis of Intracavitary Uterine Diseases in Postmenopausal Women by Hysteroscopy

“…(8) There was consistency in 99 of 101 hysteroscopic findings of atrophy; the diagnosis was endometrial hyperplasia in two cases. The highest frequency of endometrial cancer is after menopause; the mean age for this is around 60 years, (11)(12)(13)(14) although patients with postmenopausal uterine bleeding or endometrial thickening in ultrasound (≥6mm) may have benign diseases. (15) An investigation of the uterine cavity with histology of the endometrium is mandatory.…”