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What are the effects of hormone use on the uterus?
Studies have shown that long-term exposure of the uterus to estrogen alone increases a woman's risk of endometrial cancer (cancer of the lining of the uterus). The risk associated with
estrogen plus progestin appears to be much less, but some data suggest that the risk is still increased compared to nonusers. The long-term effects of the combined hormone use remain uncertain.
For example, some observational reports show that the risk of endometrial cancer for women taking estrogen plus progestin is nearly the same as for women not using estrogen (6), as long as progestin is used for 10 or more days per month (7, 8). However, another observational study showed that, compared to women who had never used hormones, women who used estrogen plus progestin with progestin for fewer than 10 days per month and women who used estrogen plus progestin daily were twice as likely to develop endometrial cancer. The same study showed that women who used estrogen plus progestin with progestin used 10-21 days per month were not at increased risk of developing endometrial cancer compared to nonusers (9).
The WHI randomized trial showed that endometrial cancer rates for women taking estrogen plus progestin daily were the same as for those taking the placebo pill. Uterine bleeding, however, was a common side effect, leading to more frequent biopsies and ultrasounds for women taking combined hormones compared to those taking a placebo pill (10).
Among women who use menopausal hormones, women who have undergone hysterectomy (surgical removal of the uterus) are generally given estrogen alone, whereas women who have not undergone this procedure are given estrogen plus
progestin.
Questions and
Answers About Menopausal Hormone Use
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