Advertisement

Hormone Replacement Therapy with Conjugated Equine Estrogens and Medroxyprogesterone Acetate

  • Michael J. Gast
Part of the Medical Science Symposia Series book series (MSSS, volume 11)

Abstract

Of drug therapies currently in common use, perhaps none has been used longer and more extensively than conjugated equine estrogens (CEE). With yearly sales approaching one billion dollars on a global basis, these hormones (which now have been routinely combined with synthetic progestins for protection of the endometrium) continue to play an important and expanding role in the health and well-being of postreproductive women as we enter the 21st century. Although initially utilized alone, CEE therapy has adopted a changing face over the 50 years of its clinical use. Following revelations in the 1970s that CEE was capable of producing proliferation, hyperplasia, and perhaps even adenocarcinoma of the uterus, CEE was routinely combined with a progestational agent to prevent such endometrial change. The most popular of those regimens is CEE and medroxyprogesterone acetate (MPA). Given at varying doses from 2.5 to 10 mg per day, the combination of CEE and MPA now has a 20-year history of providing effective hormone replacement therapy (HRT) in postreproductive women. Recently, the concept of providing HRT as a continuous combined low-dose progestin therapy (as compared to a higher dose sequential regimen) has become extremely popular. The advantages of lower daily doses and the eventual development of amenorrhea in up to 80% of women utilizing this regimen make it a very practical long-term solution for HRT [1,2]. We will discuss a number of aspects of combined hormone replacement therapy in this paper.

Keywords

Hormone Replacement Therapy Endometrial Hyperplasia Medroxyprogesterone Acetate Conjugate Equine Estrogen Combine Hormone Replacement Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Woodruff DJ, Pickar JH, for the Menopause Study Group. Incidence of endometrial hyperplasia in postmenopausal women taking conjugated estrogens (premarin) with medroxyprogesterone acetate or conjugated estrogens alone. Am J Obstet Gynecol 1994;170:1213–23.PubMedGoogle Scholar
  2. 2.
    Gelfand MM, Ferenczy A. A prospective 1-year study of estrogen and progestin in postmenopausal women: Effects on the endometrium. Obstet Gynecol 1989;74:398–402.PubMedGoogle Scholar
  3. 3.
    Lobo RA, Pickar JH, Wild RA, Walsh B, Hirvonen E, for the Menopause Study Group. Metabolic impact of adding medroxyprogesterone acetate to conjugated estrogen therapy in postmenopausal women. Obstet Gynecol 1994;84:987–95.PubMedGoogle Scholar
  4. 4.
    The Writing Group for the PEPI Trial. Effects of hormone therapy on bone mineral density, results from the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial. JAMA 1996;276:1389–96.CrossRefGoogle Scholar
  5. 5.
    The Writing Group for the PEPI Trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women: The Postmenopausal Estrogen\Progestin Interventions (PEPI) trial. JAMA, 1995;273:199–208.CrossRefGoogle Scholar
  6. 6.
    The Writing Group for the PEPI Trial. Effects of hormone replacement therapy on endometrial histology in postmenopausal women, the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial. JAMA, 1996;275:370–75.CrossRefGoogle Scholar
  7. 7.
    Paganini-Hill A, Henderson VW. Estrogen replacement therapy and risk of Alzheimer disease. Arch Intern Med 1996;156:2213–17.PubMedCrossRefGoogle Scholar
  8. 8.
    Schneider LS, Farlow MR, Henderson VW, Pagoda JM. Effects of estrogen replacement therapy on response to tacrine in patients with Alzheimer’s disease. Neurology 1996;46:1580–84.PubMedCrossRefGoogle Scholar
  9. 9.
    Lindsay R, Hart DM, Clark DM. The minimum effective dose of estrogen for prevention of postmenopausal bone loss. Obstet Gynecol 1984;63:759–63.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1997

Authors and Affiliations

  • Michael J. Gast

There are no affiliations available

Personalised recommendations