Menostar

Estrogen Alone Tx Risk

Endometrial Cancer: unopposed estrogen use incr. endometrial CA risk in pts w/ intact uterus; adding progestin may decr. risk of endometrial hyperplasia, a possible precursor to endometrial CA; use adequate diagnostic measures such as endometrial sampling to rule out malignancy if undiagnosed persistent or recurrent abnormal genital bleeding; Cardiovascular and Probable Dementia: do not use estrogen-alone tx for cardiovascular dz or dementia prevention; incr. risk of stroke and DVT in postmenopausal women 50-79 yo (WHI estrogen-alone substudy regimen = conjugated estrogens 0.625 mg/day x7y); incr. risk of probable dementia in postmenopausal women 65 yo and older (WHIMS estrogen-alone substudy regimen = conjugated estrogens 0.625 mg/day x5y); risk unknown in younger postmenopausal women; other doses and routes of conjugated estrogens or other estrogen-alone products not studied, therefore adverse cardiovascular events and dementia relevance is unknown; weigh risk/benefit; use lowest effective estrogen dose, shortest duration based on individual tx goals and risks

Estrogen Plus Progestin Tx Risk

Cardiovascular and Probable Dementia: do not use estrogen + progestin tx for cardiovascular dz or dementia prevention; incr. risk of MI, stroke, and PE/DVT in postmenopausal women 50-79 yo (WHI estrogen/progestin substudy regimen = conjugated estrogens 0.625 mg/day w/ medroxyprogesterone 2.5 mg/day x6y); incr. risk of probable dementia in postmenopausal women 65 yo and older (WHIMS estrogen/progestin substudy regimen = conjugated estrogens 0.625 mg/day w/ medroxyprogesterone 2.5 mg/day x4y); risk unknown in younger postmenopausal women; Breast CA: estrogen + progestin tx may incr. risk of invasive breast CA in postmenopausal women (WHI estrogen/progestin substudy regimen = conjugated estrogens 0.625 mg/day w/ medroxyprogesterone 2.5 mg/day x6y); doses and routes of other estrogen progestin combos not studied, therefore adverse cardiovascular events, dementia, and breast CA relevance is unknown; weigh risk/benefit; use lowest effective estrogen dose, shortest duration based on individual tx goals and risks