Estrogen Plus Progestin Risks

April 2006

Attempting to combat the risk of endometrial cancer in postmenopausal women taking estrogen, doctors added progestin to hormone replacement therapies. However, recent evidence shows that this combination of hormones has its own set of risks.

Recently, two reports from the Women’s Health Initiative, a government-sponsored study of postmenopausal women, describes the safety difference between estrogen only and estrogen plus progestin. When comparing the two, long-term estrogen use is less risky than long-term estrogen plus progestin use.

Some findings to consider:

• Breast cancer risk begins to rise after three to four years of estrogen plus progestin use.
• Estrogen users are about 50% more likely to get blood clots than non-users.
• Estrogen plus progestin users are twice as likely to get blood clots as non-users.

These findings have fueled the Food and Drug Administration (FDA) to advise women to consider taking the lowest does of estrogen and progestin allowed for symptom relief.

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