High-dose progesterone can help treat endometrial hyperplasia and endometrial cancer.
Progesterone is a hormone naturally secreted by the ovaries during a normal menstrual cycle. A lack of progesterone to oppose the effects of estrogen on the womb can lead to an abnormal growth of cells (a precancerous condition known as endometrial hyperplasia). This might result in endometrial cancer or cancer of the uterus if left untreated. High-dose progesterone can be given to women to prevent this overgrowth from developing to cancer, or at the early stages of cancer if surgery to remove the womb is not an option.
Endometrial Cancer
Endometrial carcinoma occurs mostly after the menopause, but there is increasing prevalence in pre-menopausal women because of risk factors such as obesity, diabetes and high blood pressure. About 30 percent of cases of endometrial hyperplasia progress to endometrial carcinoma, so the treatment of choice is usually complete hysterectomy and removal of the ovaries.
If you are pre-menopausal or can not undergo surgery for other reasons, that might not be acceptable for you, so high-dose progesterone might be used to delay the need for surgery.
Symptoms of Endometrial Cancer
The most common symptom of endometrial cancer is bleeding after the menopause. Other symptoms include unusual vaginal bleeding, pelvic pain, pain during intercourse, painful or difficult urination and bleeding after intercourse. If this happens it is important to see your gynecologist.
Effects
It is important to receive treatment as early as possible, as high-dose progesterone treatment of endometrial hyperplasia has the best response rate, with a high percentage of regression to normal cells, followed by early treatment of endometrial carcinoma and reoccurrences.
Clinical trials have shown that evidence for its effectiveness in recurrent endometrial cancer is not good. By that stage most patients have undergone surgery and chemotherapy. High-dose progesterone can be used as palliative therapy in recurring endometrial cancer but it does not cure it. Whatever stage your disease is at, it is vital to stick to any follow-up appointments made for you.
Other Uses
Progesterone is used in the contraceptive pill at lower doses, and in hormone replacement therapy, where its presence can help protect you against uterine cancer after menopause.
Side Effects
Side effects can include breast tenderness, breast leakage, hair growth, hair loss, weight gain, weight loss, breakthrough bleeding, nausea, insomnia, jaundice and vaginal spotting. If you are taking high-dose progesterone and are concerned about any side effects, you should discuss them with your doctor.
Serious Side Effects
Occasional serious side effects include blood clots. The risk of developing of blood clots is much higher if you smoke, so if you smoke, your doctor is likely to strongly encourage you to stop.
There is an increased risk of breast cancer, stroke, heart attack and blood clots in the lungs in post-menopausal women age 50 to 79, and increased risk of dementia in women older than 65 when used in combination with estrogen for five years. If you are post-menopausal, you should discuss this with your doctor, who might discuss other options such as surgery.
If you are diabetic, you might experience difficulty controlling your blood sugar. Careful monitoring of your medication is needed, and it might have to be reviewed.
Considerations
There are progesterone receptors in breast cancer, so your physician will usually avoid progesterone if you have had breast cancer in the past.
Progesterone should not be used to prevent heart disease or dementia.
Tags: endometrial cancer, endometrial hyperplasia, after menopause, blood clots, breast cancer, your doctor, bleeding after
