Petra Stute (Deputy Head Gynecological Endocrinology and Reproductive Medicine) , Linus Josef Walker (Medical Doctoral Student) , Astrid Eicher (Medical Doctoral Student) , Elena Pavicic (Medical Doctoral Student) , Argyrios Kolokythas (Gynecologic Reproductive Endocrinology and Infertility Fellow) , Susanne Theis (Senior Physician Gynecological Endocrinology and Reproductive Medicine) , Marc von Gernler (Information Specialist) , Michael von Wolff (Head Gynecological Endocrinology and Reproductive Medicine) , Sabrina Vollrath (Senior Physician Gynecological Endocrinology and Reproductive Medicine)
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Progestogens for endometrial protection in combined menopausal hormone therapy: A systematic review
Menopausal women with an intact uterus choosing estrogens for menopausal symptom relief require a progestogen for endometrial protection. The aim of this systematic review was to evaluate the risks of endometrial hyperplasia resp. malignancy with different progestogens used in combined MHT. Overall, 84 RCTs were included. We found that 1) most studies were done with NETA, followed by MPA, MP and DYD and LNG, 2) most progestogens were only available as oral formulations, 3) the most frequently studied progestogens (oral MP, DYD, MPA, oral and transdermal NETA, transdermal LNG) were assessed in continuously as well as in sequentially combined MHT regimens, 4) FDA endometrial safety criteria were only fulfilled for some progestogen formulations, 5) most studies demonstrated endometrial protection for the progestogen dose and time period examined. However, 6) study quality varied which should be taken into account, when choosing a combined MHT, especially if off-label-use is chosen.
期刊介绍：
Best Practice & Research Clinical Endocrinology & Metabolism is a serial publication that integrates the latest original research findings into evidence-based review articles. These articles aim to address key clinical issues related to diagnosis, treatment, and patient management.
Each issue adopts a problem-oriented approach, focusing on key questions and clearly outlining what is known while identifying areas for future research. Practical management strategies are described to facilitate application to individual patients. The series targets physicians in practice or training.
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