Progestogens and venous thromboembolism among postmenopausal women using hormone therapy.
نویسندگان
چکیده
Hormone therapy (HT) is the most effective treatment for correcting menopausal symptoms after menopause. HT initially consisted of estrogens alone and progestogens were secondly added to estrogens for preventing the risk of endometrial cancer associated to estrogens use. Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a major harmful effect of HT. It is now well known that oral and transdermal estrogens are differentially associated with VTE risk but progestogens may be another important determinant of the thrombotic risk among HT users. Both randomized controlled trials and meta-analysis of observational studies suggested that the VTE risk was higher among users of estrogens plus progestogens than among users of estrogens alone. With respect to the different pharmacological classes of progestogens, there is evidence for a deleterious effect of medroxyprogesterone acetate on VTE risk. In addition, observational studies showed that norpregnane derivatives were significantly associated with an increased VTE risk whereas micronized progesterone could be safe with respect to thrombotic risk. The effect of tibolone on VTE risk remains uncertain. In conclusion, progestogens may have differential effects on VTE risk according to the molecules and therefore represent an important potential determinant of the thrombotic risk among postmenopausal women using estrogens.
منابع مشابه
Postmenopausal Hormone Therapy and Risk of Idiopathic Venous Thromboembolism
Objective—Oral estrogen therapy increases venous thromboembolism risk among postmenopausal women. Although recent data showed transdermal estrogens may be safe with respect to thrombotic risk, the impact of the route of estrogen administration and concomitant progestogens is not fully established. Methods and Results—We used data from the E3N French prospective cohort of women born between 1925...
متن کاملPostmenopausal hormone therapy and risk of idiopathic venous thromboembolism: results from the E3N cohort study.
OBJECTIVE Oral estrogen therapy increases venous thromboembolism risk among postmenopausal women. Although recent data showed transdermal estrogens may be safe with respect to thrombotic risk, the impact of the route of estrogen administration and concomitant progestogens is not fully established. METHODS AND RESULTS We used data from the E3N French prospective cohort of women born between 19...
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There is evidence that postmenopausal women who take hormone replacement therapy develop biochemical hypercoagulability, expressed by increased activity of coagulation enzymes. Such effects are observed whether estrogen is given alone or in combination with progestogens, orally or transdermally. Two recent randomized, double-blind clinical trials have shown that hormone replacement therapy lead...
متن کاملHormone therapy and risk of venous thromboembolism among postmenopausal women.
Despite a decrease in the use of postmenopausal hormone therapy (HT) over the last decade, many women are still prescribed this treatment, as it remains the most effective means of counteracting climacteric symptoms. Its use declined when it was shown that HT increases the risk of breast cancer, stroke and venous thromboembolism (VTE). Nevertheless, that benefit/risk ratio was established among...
متن کاملDoes the progesterone receptor genetic polymorphism +331G/A hPR influence the risk of venous thromboembolism among postmenopausal women using hormone therapy? The ESTHER Study.
Hormone therapy (HT) increases venous thromboembolism (VTE) risk among postmenopausal women. Data on the influence of steroids receptors polymorphisms on this association remain scarce. Since progesterone receptor (hPR) is expressed in human veins and specific progestogens increase VTE risk, we investigated the impact of the functional +331G/A hPR polymorphism on the association of VTE with HT....
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ورودعنوان ژورنال:
- Maturitas
دوره 70 4 شماره
صفحات -
تاریخ انتشار 2011