Do progestogens taken with HRT reduce its benefits?

If you are on oestrogen replacement therapy and you have not had a hysterectomy (hysterectomy), progestogen must also be taken (HRT and progestogen). Medroxyprogesterone acetate (Provera) and dydrogesterone (Duphaston) do not seem to have any detrimental action on cholesterol chemistry. Other progestogens, particularly norethisterone and levonorgestrel, may partly offset the benefits of the oestrogen. One paper, however, published in 1996 from data obtained from the American Nurses’ Health Study suggests that the progestogen component of combined hormone replacement therapy may actually enhance the benefits of oestrogen on the coronary arteries.

The latest information from the HERS study suggests that HRT with progestogen does not protect against heart disease (Q 27.3)

Q 27. 1 HRT help me with the psychological difficulties that I am experiencing around?
Q 27. 2 HRT help my mental ability?
Q 27. 3 Can HRT reduce my chance of developing heart disease?
Q 27. 4 How does HRT protect against coronary heart disease?
Q 27. 5 If I am at particular risk of heart disease, can HRT still help?
Q 27. 6 Do progestogens taken in combination with oestrogen replacement therapy have an adverse effect on heart protection?
Q 27. 7 How long should HRT be taken to reduce the risk of heart disease?
Q 27. 8 Is there any evidence that HRT will protect my bones?
Q 27. 9 Would the dose (strength) of my HRT influence its ability to protect my bones?
Q 27. 10 Are there other treatments apart from HRT for osteoporosis?
Q 27. 11 Would HRT help my skin?
Q 27. 12 Can hormone replacement therapy cure all my menopausal symptoms?
Q 27. 13 How prevalent is cancer of the breast?
Q 27. 14 What factors influence the chance of breast cancer developing?
Q 27. 15 What is the relationship between HRT and breast cancer?
Q 27. 16 I have benign breast disease. Can I take HRT?
Q 27. 17 Does a history of breast cancer mean that HRT is absolutely contraindicated?
Q 27. 18 If I started HRT early (aged 30 to 45), does this influence my chance of developing breast cancer?
Q 27. 19 Does hormone replacement therapy increase the risks of cancer of the womb?
Q 27. 20 I have had endometrial cancer and now have menopausal problems. Can I take HRT?
Q 27. 21 Does HRT have a relationship to ovarian cancer?
Q 27. 22 How does HRT relate to a blood clot (DVT - deep venous thrombosis or pulmonary embolism)?
Q 27. 23 I have varicose veins. Can I take HRT?
Q 27.24 Should HRT be discontinued before I have a major operation or leg surgery?
Q 27. 25 Does HRT increase life-expectancy?
Q 27. 26 I am still seeing periods. Could HRT have any benefits for me?
Q 27. 27 I have been told that I have fibroids. Can I take HRT?
Q 27. 28 What happens if I decide not to take HRT?
Q 27. 29 Doctors seem to promote HRT but the media cause me anxiety. Who is right?
Q 27. 30 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London.
I do hope that you find the answers to your questions in the patient information and medical advice provided. If you still have unanswered questions, please consider entering them into one of our forums and I will try to assist you.
DISCLAIMER

The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.