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Continuous combined hormone replacement therapy and endometrial hyperplasia

BMJ 2002; 325 doi: (Published 03 August 2002) Cite this as: BMJ 2002;325:231

Risk of developing cancer is very low

  1. David F Archer, director, clinical research centre and professor of obstetrics and gynaecology. (
  1. The Jones Institute for Reproductive Medicine 601 Colley Avenue, Norfolk, VA 23507 USA

    Papers (p 239)

    The use of continuous combined hormone replacement therapy, consisting of an oestrogen and a progestogen taken daily by postmenopausal women, is increasing. Its possible benefits are the prevention of endometrial hyperplasia and reduction in the occurrence of endometrial bleeding with time. Daily exposure to oestrogen and progestin without a break may be more important than using oestrogen intermittently in prevention of disease. A major concern is the occurrence of endometrial cancer in women using cyclic or sequential hormone replacement with the progestin being given for either less than 10 days each month, 10-16 days each month, or every three months for 14 days. 1 2 The case-control studies indicate a significant increased risk in endometrial cancer with a reduction in the number of days of exposure to progestin. The use of continuous combined hormone replacement therapy not only does not increase the incidence of endometrial cancer but could even be protective compared with non-use of hormone replacement.3

    Most clinical trials of continuous combined hormone replacement therapy have been for one year in order to obtain …

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