Unopposed Estrogen Therapy OK for Some Women

Menopausal women on estradiol should anticipate uterine bleeding and possible endometrial biopsy

FRIDAY, March 9 (HealthDay News) -- Estrogen therapy without a progestational agent may be an option for some postmenopausal women, according to results from two randomized trials presented in the March 1 issue of Obstetrics & Gynecology.

Wendy J. Mack, Ph.D., from the University of Southern California Keck School of Medicine in Los Angeles, and colleagues randomized 218 postmenopausal women with intact uteri to 1 mg of micronized 17β-estradiol or placebo to compare the rates of endometrial hyperplasia, bleeding episodes, and interventions.

Nine women in the estradiol group developed hyperplasia, all but one of which were simple hyperplasia without atypia. Women in the estradiol group were also more likely to have an endometrial biopsy and at least one episode of uterine bleeding, especially if they were obese.

"The benefits of estrogen or hormone therapy for relief of vasomotor symptoms, especially in younger menopausal women (e.g., in their 50s, the decade when symptoms are most likely present), will need to be weighed against these risks," according to Cheryl Iglesia, M.D., from Washington Hospital Center in Washington, D.C., in an accompanying editorial. "Periodic risk re-assessment should be conducted every six to 12 months.

One of the authors of the study serves as a consultant for Wyeth, Berlex, Merck, RPR, Novo Nordisk, and Solvay pharmaceutical companies.

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