Progestin therapy

Table 11.2. Uterine effects of estrogen plus progestin therapy and raloxifene (Euralox study) (Neven et al. 2004)...

Estrogen/progestin therapy vs. raloxifene Average values in % ... 

In conclusion, a shorter time since menopause and surgical menopause are important predictors of hot flashes not only before but also during treatment with raloxifene. Previous estrogen/progestin therapy also increases the risk... 

Mullins CD, Ohsfeldt RL (2003) Modeling the annual costs of postmenopausal prevention therapy raloxifene, alendronate, or estrogen-progestin therapy. J Managed Care Pharm 9(2) 150—158... 

Progestins are nsed for varions menstmal cycle disorders, for functional uterine bleeding of various origins, and as a contraceptive. Progestin therapy is also used to treat endometriosis and endometrial carcinomas. Progesterone is not effective when taken orally due to intensive metabolism, and therefore it is used by either parenteral or transvaginal introduction. 

Concomitant progestin therapy When estrogen is prescribed for a postmenopausal woman with a uterus, also initiate progestin to reduce the risk of endometrial cancer. 

Cardiovascular disorders Estrogen and estrogen/progestin therapy have been associated with an increased risk of cardiovascular events (eg, Ml and stroke, venous thrombosis, PE [venous thromboembolism]). Manage risk factors for cardiovascular disease appropriately. 

For information concerning adverse reactions associated with combined estrogen-progestin therapy, refer to the Oral Contraceptives monograph. 

Lobo RA, Gibbons WE. The role of progestin therapy in breast disease and central nervous system function. J Reprod Med 1982 27(Suppl 8) 515-21. 

Grey AB, Cundy TF, Reid IR. Continuous combined oes-trogen/progestin therapy is well tolerated and increases bone density at the hip and spine in post-menopausal osteoporosis. Clin Endocrinol (Oxf) 1994 40(5) 671-7. 

The Heart and Estrogen/Progestin Replacement Study (HERS) was undertaken to determine whether estrogen plus progestin therapy alters the risk for CHD events in postmenopausal women with established CAD. A total of 2763 women (mean age 66.7 years)... 

Women with secondary amenorrhea who have been estrogen deficient for 12 months or longer also should be given low-dose estrogen replacement initially to avoid adverse effects such as mastalgia and nausea. However, the dose can be titrated up to maintenance levels over a 6-month period, and progestin therapy can be instituted with the initiation of estrogen therapy. Women with a brief history of sec-... 

Ylikorkala O, Jaakkola S, Lyytinen H, Pukkala E. Endometrial cancer in postmenopausal women using estradiol-progestin therapy. Obstet Gynecol 2009 114 1197-204. 

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