Indications and Efficacy of Progestogen-Monotherapy as Menopause Hormone Therapy: A Narrative Review - PubMed
4 hours ago
- #Menopause Hormone Therapy
- #Progestogen Monotherapy
- #Gynecologic Oncology
- Progestogen monotherapy is a viable alternative for menopausal hormone therapy (MHT) in women with contraindications to estrogen.
- Indications include gynecologic malignancies, prior venous thromboembolism, coronary artery disease, compensated liver disease, and endometriosis.
- Contraindications are limited to unexplained abnormal vaginal bleeding and personal history of breast cancer, with caution for meningioma.
- Progestogens provide significant relief for vasomotor symptoms across oral, intramuscular, and transdermal preparations.
- Micronized progesterone benefits sleep quality, while synthetic progestins like medroxyprogesterone acetate and norethindrone acetate offer bone protection.
- Effects on mood are neutral overall, but breast cancer risk remains uncertain due to limited studies.
- Research is constrained by heterogeneous methodologies, small sample sizes, and lack of trials comparing with standard MHT.
- Optimal use can be tailored: micronized progesterone for sleep, norethindrone acetate for bone health, and progestins with antineoplastic properties for tumors.
- Larger, high-quality studies are needed to better define long-term safety and efficacy.