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Association of Ovarian and Uterine Cancers With Postmenopausal Hormonal Treatments

NEVES-E-CASTRO, MANUEL MD

Clinical Obstetrics and Gynecology: September 2008 - Volume 51 - Issue 3 - p 607-617
doi: 10.1097/GRF.0b013e318180b988
Evidence-Based Approach to Menopause

During hormone treatments for the relief of the symptoms of postmenopausal women a number of side effects may occur. Some may be due to the wrong choice of the steroids used for treatment or to the route of administration. However, the more important ones deserving much attention are the rare occurrences of malignancies of the uterus and ovaries. The risk for ovarian cancer, if it exists, is minimal and clinically irrelevant. Estrogen only treatments are used only in hysterectomized women. Continuous combined estrogen-progestin treatments have a very low risk of association with endometrial cancers compared with sequential regimens. Tibolone may be associated with a very small risk for endometrial cancers and thus must be properly monitored by transvaginal ultrasound. Breast cancer patients being treated with tamoxifen require careful attention to the endometrium to exclude a carcinoma. For the protection of the endometrium, a progestin-releasing intrauterine devise is an attractive choice. Raloxifene used for a long time to prevent osteoporosis is safe for the endometrium. None of the above-mentioned side effects is enough to prevent a physician from using hormone treatment in postmenopausal women if there are no past or current contraindications.

Clinica de Feminologia Holística, Lisbon, Portugal

Correspondence: Manuel Neves-e-Castro, MD, Clinica de Feminologia Holística, Av. Ant°. Aug°. Aguiar 24 Lisboa 1050-016, Portugal. E-mail: manuel@neves-e-castro.org

© 2008 Lippincott Williams & Wilkins, Inc.