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The impact of micronized progesterone on cardiovascular events - a systematic review.
Climacteric. 2022 08; 25(4):327-336.C

Abstract

Biologically identical menopausal hormone therapy (MHT) including micronized progesterone (MP) has gained much attention. We aimed to assess the impact of MP in combined MHT on venous and arterial thromboembolism (VTE/ATE) (e.g. deep venous thrombosis/pulmonary embolism, myocardial infarction [MI] and ischemic stroke). Articles were eligible if they provided endpoints regarding cardiovascular events and use of exogenous MP. Literature searches were designed and executed for the databases Medline, Embase, CINAHL, the Cochrane Library, ClinicalTrials.gov and interdisciplinary database Web of Science. Twelve studies consisting of randomized controlled trials (RCTs), case-control studies and prospective or retrospective cohort studies were included, and risk of bias was assessed. Only a minority assessed thromboembolic events as a primary endpoint, showing that in contrast to norpregnane derivatives, primary and recurrent VTE risk was not altered by combining estrogens with MP, which was also true for ischemic stroke risk. Similarly, in placebo-controlled RCTs assessing VTE/ATE as adverse events there were no significant intergroup differences. Studies on MI as a primary endpoint are missing. In conclusion, while available data suggest that MP as a component in combined MHT may have a neutral effect on the vascular system, more RCTs investigating the impact of MP alone or in combined MHT on vascular primary endpoints are needed.

Authors+Show Affiliations

Medical Faculty of the University of Bern, Bern, Switzerland.Medical Faculty of the University of Bern, Bern, Switzerland.Medical Library, University Library Bern, University of Bern, Bern, Switzerland.Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland.Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

35112635

Citation

Kaemmle, L M., et al. "The Impact of Micronized Progesterone On Cardiovascular Events - a Systematic Review." Climacteric : the Journal of the International Menopause Society, vol. 25, no. 4, 2022, pp. 327-336.
Kaemmle LM, Stadler A, Janka H, et al. The impact of micronized progesterone on cardiovascular events - a systematic review. Climacteric. 2022;25(4):327-336.
Kaemmle, L. M., Stadler, A., Janka, H., von Wolff, M., & Stute, P. (2022). The impact of micronized progesterone on cardiovascular events - a systematic review. Climacteric : the Journal of the International Menopause Society, 25(4), 327-336. https://doi.org/10.1080/13697137.2021.2022644
Kaemmle LM, et al. The Impact of Micronized Progesterone On Cardiovascular Events - a Systematic Review. Climacteric. 2022;25(4):327-336. PubMed PMID: 35112635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of micronized progesterone on cardiovascular events - a systematic review. AU - Kaemmle,L M, AU - Stadler,A, AU - Janka,H, AU - von Wolff,M, AU - Stute,P, Y1 - 2022/02/03/ PY - 2022/2/4/pubmed PY - 2022/7/12/medline PY - 2022/2/3/entrez KW - Micronized progesterone KW - combined estrogen–progestogen therapy KW - menopausal hormone therapy KW - myocardial infarction KW - pulmonary embolism KW - stroke KW - systematic review KW - venous thromboembolism SP - 327 EP - 336 JF - Climacteric : the journal of the International Menopause Society JO - Climacteric VL - 25 IS - 4 N2 - Biologically identical menopausal hormone therapy (MHT) including micronized progesterone (MP) has gained much attention. We aimed to assess the impact of MP in combined MHT on venous and arterial thromboembolism (VTE/ATE) (e.g. deep venous thrombosis/pulmonary embolism, myocardial infarction [MI] and ischemic stroke). Articles were eligible if they provided endpoints regarding cardiovascular events and use of exogenous MP. Literature searches were designed and executed for the databases Medline, Embase, CINAHL, the Cochrane Library, ClinicalTrials.gov and interdisciplinary database Web of Science. Twelve studies consisting of randomized controlled trials (RCTs), case-control studies and prospective or retrospective cohort studies were included, and risk of bias was assessed. Only a minority assessed thromboembolic events as a primary endpoint, showing that in contrast to norpregnane derivatives, primary and recurrent VTE risk was not altered by combining estrogens with MP, which was also true for ischemic stroke risk. Similarly, in placebo-controlled RCTs assessing VTE/ATE as adverse events there were no significant intergroup differences. Studies on MI as a primary endpoint are missing. In conclusion, while available data suggest that MP as a component in combined MHT may have a neutral effect on the vascular system, more RCTs investigating the impact of MP alone or in combined MHT on vascular primary endpoints are needed. SN - 1473-0804 UR - https://www.unboundmedicine.com/medline/citation/35112635/The_impact_of_micronized_progesterone_on_cardiovascular_events_-_a_systematic_review. DB - PRIME DP - Unbound Medicine ER -