Estra Pellets

1. ESTROGENS HAVE BEEN REPORTED TO INCREASE THE RISK OF ENDOMETRIAL CARCINOMA.

Three independent case control studies have shown an increased risk od endometrial cancer in postmenopausal women exposed to exogenous estrogens for prolonged periods. 1-3 The risk was independent of other known risk factors for endometrial cancer. These studies are further supported by the finding that incidence rates of endometrial cancer have increased sharply since 1969 in eight different areas of the United States with population-based cancer reporting systems, an increase which may be related to rapidly expanding use of estrogens during the last decade. 4

The three case control studies reported that the riskof endometrial cancer in estrogen users was about 4.5 to 13.9 times greater than in nonusers. The rik appears to depend on both duration of treatment 1 and on estrogen dose. 3 In view of these findings, when estrogens are used for the treatment of menopausalsymptoms, the lowest dose that will controlsymptoms should be utilized and medication should be discontinuedas soon as possible. When prolonged treatment is medically indicated, the patient should be reassessedon at least a semiannual basis to determine the need for continued therapy.

Although the evidence must be considered preliminary, one study suggests that cyclic administration in low doses of estrogen may carry less risk than continuos administration, 3 it therefore appears prudent to utilize such a regimen.

Close clinical surveillance of all women taking estrogens is important. In all cases of undiagnosed persistant or recurring abnormal vaginal bleeding, adequate diagnostic measures should be undertaken to rule out malignancy.

There is no evidence at present that "natural" estrogens are more or less hazardous than "synthetic" estrogens at equiestrogenic doses.

2. ESTROGENS SHOULD NOT BE USED DURING PREGNANCY The use of female sex hormones, both estrogens and progestens, during early pregnancy may seriously damage the offspring. It has been shown that females exposed in utero to diethylstilbestrol, a non-steroidal estrogen, have increased risk of developing in later life a form of vaginal or cervical cancer that is ordinarily e...