oa SA Pharmaceutical Journal - Progestogen use in the menopause : clinical



Recent publications of prospective randomised controlled trials have called into question the role of progestogen use in menopausal women. <BR>Progestogens are necessary to protect the endometrium from the hyperplastic effect of oestrogen. <BR>Progestogens differ markedly in their effects on different organ systems. <BR>In the cardiovascular system, the less androgenic progestogens have potential advantages as regards their effect on lipid profile, direct vascular effect, insulin resistance and haemostasis. <BR>By virtue of their effect on breast tissue enzymes, progestogens may increase the concentration of oestradiol in breast tissue. Progestins differ in this effect. <BR>Less androgenic progestogens have a favourable effect on the apoptosis proliferation ratio in breast tissue. <BR>Individualisation of menopausal hormone therapy is important, especially in the high-risk patient.


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