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Obstet Gynecol. 1979 Apr;53(4):403-10.

Endometrial pathology and estrogens.


Endometrial biopsies were obtained from 46 hypogonadal patients (44 with gonadal dysgenesis; 2 panhypopituitary) who were receiving estrogen-progestogen therapy. Endometrial abnormalities occurred only in patients receiving a total lifetime conjugated estrogen dose of greater than or equal to 2500 mg and who had received estrogen treatment for a period longer than 4.2 years. The biopsy outcome was significantly related (P less than 0.01) to the estrogen dose at time of biopsy and to the total lifetime dose (P less than 0.05). The progestational drugs administered did not protect against development of endometrial abnormalities. None of the abnormal endometrial patterns were associated with abnormal vaginal bleeding.


In order to elucidate the role of exogenous estrogens in the pathogenesis of endometrial hyperplasia and carcinoma, endometrial biopsies were obtained from 46 hypogonadal patients undergoing estrogen-progesterone therapy. It was found that abnormal endometrial patterns occurred only in patients who had received a lifetime dose of 2500 mg Premarin or its equivalent and who had undergone estrogen therapy for - or - = 4.2 years. The biopsy outcome also differed significantly according to whether the current dose of Premarin was 1.25 mg. Duration of therapy independent of dose caused significant differences in biopsy results after 84 months. No correlation was found between the endometrial histology and the patient's weight, blood pressure, or bleeding pattern. Since total lifetime estrogen dose, current estrogen dose, and duration of estrogen therapy appear to have important implications in the histologic development of the endometrium, patients should be administered the lowest therapeutic dose in a perhaps intermittant pattern. In addition, all such patients should undergo periodic examination to detect silent endometrial abnormalities.

[Indexed for MEDLINE]

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