The Prevention and Treatment of Endometrial Pathology in Postmenopausal Women receiving Exogenous Estrogens
Most gynecologists will now accept that approximately 25% of women of menopausal age would be sufficiently distressed by symptoms of estrogen deficiency to warrant specific estrogen therapy proven to be of benefit by many trials1–3. More recently, Hammond et al. 4 have demonstrated that replacement estrogen therapy has longterm metabolic benefits in significantly reducing the incidence of strokes, heart attacks, hypertension, osteoporosis and fractures. However, there is a widespread fear that this treatment will result in an increased incidence of endometrial carcinoma, although until 5 years ago it was generally believed that there was no such risk. There are now many case-controlled studies from the United States5–9 showing between a five-fold and 15-fold increased risk of cancer of the uterus in these patients. This risk is both duration-dependent and dose-dependent.
KeywordsEndometrial Cancer Endometrial Carcinoma Estrogen Therapy Atypical Hyperplasia Endometrial Biopsy
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