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Continuous combined HRT-safe for the endometrium.

3 August 2002

A study recently reported in the British Medical Journal : BMJ 2002;325:239 (3 August 2002) confirmed the safety of long term continuous combined HRT in terms of effect on the endometrium. 534 women taking an oral continuous combined preparation of 2mg oestradiol and 1mg norethisterone acetate daily, took part in the study. Follow up was for 4.4 years (range 1.1-5.9 years). There were no cases of endometrial hyperplasia nor malignancy. In women who had hyperplasia before the study, the endometrium returned to normal during treatment.

These findings confirm the belief that if HRT is taken long term, this type of continuous combined HRT is safe in terms of endometrial effect. Previous studies have shown that long term sequential HRT confers an increased risk of endometrial cancer. Therefore, if, after balancing risks against benefits, it is decided to use HRT long term, consideration should be given to using continuous combined therapy, and to change from sequential to continuous combined when possible. Continuous combined HRT can be offered when the women is known to be postmenopausal by having had 1 year of amenorrhoea, or at the age of 54.

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