The role of progestogens in hormone replacement

The advantages of hormone replacement in peri- and postmenopausal women are incontestable, but as in any other treatment, side effects can occur. With physiological estrogens such as estradiol, estradiol valerate and conjugated estrogens, osteoporosis and cardiovascular diseases can be prevented. Due to the cessation of climacteric complaints, the general state of health will be improved. The type and dose of progestogens should be selected in a way to prevent endometrium proliferation. The partial effects of progestogens are explained by different expressions of different ligands of hormone receptors. Orally administered progestogens inhibit the hepatocellular effect of estradiol depending on the dose and type of steroid. Different stud ies have shown th at estrogen-progestogen treatment is associated with significant reductions of cardiovascular mortality and morbidity. Progestogens are indispensable in hormone replacement therapy because of their protective effects against endometrial cancer and hyperplasia. (C) 2001 Prous Science. All rights reserved.