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This randomized prospective study compared two different therapeutic regimens, demonstrating that co-treatment with progestin is more accepted by the patients that co-treatment with gonadotropin-releasing hormone analogue.
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HT, the overall risks of HT were said to outweigh the benefits in the study group.
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Of the 4246 events diagnosed among non-users of hormonal contraception or among users of products included in this study, 2847 (67.
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During the peri-menopausal and post-menopausal periods, estrogen depravation contributes to increasing levels of low-density lipoprotein (LDL) cholesterol and triglycerides (TGs) and decreasing levels of high-density lipoprotein (HDL) cholesterol ().
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Conclusions Relatively short-term combined estrogen plus progestin use increases incident breast cancers, which are diagnosed at a more advanced stage compared with placebo use, and also substantially increases the percentage of women with abnormal mammograms.
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Some studies in women who use combined oral contraceptives that contain both estrogen and a progestin have reported an increase in the risk of developing breast cancer, particularly at a younger age and apparently related to duration of use.
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For women genetically predisposed to venous thrombosis who still want hormonal contraception, however, a progestogen only pill or hormone releasing intrauterine device seems to be the appropriate first choice.
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Bias and lack of adjustment for confounders at the level of the individual studies cannot be corrected in the meta-analysis, so the validity of these results is dependent on quality of the primary observational data.
As this strong association with estrogen-only hormone therapy has also been seen with endometrial cancer, many studies, including 48 randomized trials, have examined the effect of combined estrogen and progestin postmenopausal hormone therapy on the development of endometrial pathology ().
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The data consisted of time at risk (woman years) and number of venous thrombotic events for each combination of hormonal contraception, length of use, age band, and educational level.
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Up to 10% of pregnancies reported in clinical studies of progestin-only oral contraceptive users are extrauterine.
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Ectopic pregnancy is possible with contraception failure because some progestin-only contraceptives reduce ectopic pregnancy risk substantially, but prevent ectopic pregnancy less effectively than intrauterine pregnancy.
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Correspondence Emilio Perucca MD, PhD, Clinical Pharmacology Unit, Department of Internal Medicine and Therapeutics, University of Pavia, Piazza Botta 10, 27100 Pavia, Italy.
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