The role of megestrol acetate as an alternative to conventional hormone replacement therapy

@article{Farish2000TheRO,
  title={The role of megestrol acetate as an alternative to conventional hormone replacement therapy},
  author={Elizabeth Farish and Judith F Barnes and F O’Donoghue and C. D. Fletcher and K Ekevall and D. McKay Hart},
  journal={Climacteric},
  year={2000},
  volume={3},
  pages={125 - 134}
}
Objective To investigate the effect of megestrol acetate on menopausal symptoms, lipid metabolism, bone metabolism and coagulation. Methods In a prospective observational study, 71 postmenopausal women, for whom conventional hormone replacement therapy (HRT) was unsuitable, were treated with megestrol acetate 40 mg per day. At 0, 3, 6 and 12 months, fasting lipoproteins, bone biochemistry and thrombophilia profiles were measured and symptom score cards (Greene climacteric scale) completed. Bone… 
Megestrol acetate-induced weight gain does not negatively affect blood lipids in elderly men: effects of resistance training and testosterone replacement.
TLDR
It appears from the data that MA does not cause adverse blood lipid changes, and the decision to use it should be based on other factors.
Megestrol acetate-induced weight gain does not negatively affect blood lipids in elderly men: effects of resistance training and testosterone replacement.
TLDR
It appears from the data that MA does not cause adverse blood lipid changes, and the decision to use it should be based on other factors.
Management of surgically hypogonadal patients unable to take sex hormone replacement therapy.
  • L. Nieman
  • Medicine
    Endocrinology and metabolism clinics of North America
  • 2003
TLDR
With regards to the prevention of osteoporosis and fractures in men and women, bisphosphonates are the most potent of the currently available agents; calcitonin is less effective and PTH has a large beneficial effect but is not yet available and is less well studied.
Overview on the effects of progestins on bone.
TLDR
From the data there are no indications that the various progestins, used in clinical practice, have either a bone-protective or an oestrogen antagonistic activity.
Treatment of menopausal symptoms: what shall we do now?
TLDR
Oestrogen alone or combinations of oestrogen and progestagen are likely to be the most effective treatments for menopausal hot flushes and vaginal dryness and Tibolone is as effective as HRT, however, and might also improve libido.
Hormone therapy after endometrial cancer.
TLDR
Generally after hysterectomy, at least for patients with cardiovascular risk factors, the preference today is to use low-dose estrogen therapy (patches, gels) instead of CCEPT, and this also is now recommended for patients after endometrial cancer.
Hormone therapy after endometrial cancer
TLDR
Generally after treatment for endometrial cancer, current preference should be for low-dose oestrogen monotherapy rather than continuous combined therapy with progestogen addition in view of the increased risk of breast cancer and cardiovascular disease found with the latter regimen.
Menopausal hot flushes and night sweats: where are we now?
TLDR
Hot flushes are caused by changes in the central nervous system associated with estrogen withdrawal and are best treated with estrogen replacement therapy, and Objective monitoring of hot flushes indicates that placebo has little to no effect on their improvement.
Progestagens androgenic action on the bone of male castrated mice.
TLDR
The results indicate that only NETA at the dose used in hormonal therapy for prevention of osteoporosis has a slight protective effect against bone mineral loss in castrated mice.
Hormone Therapy after Endometrial Cancer
TLDR
Although no study has established an increased rate of recurrences or mortality, alternatives such as phytopreparations, tibolone, or, in, particular, psychotherapeutic drugs such as venlafaxine should be considered for the relief of climacteric complaints.
...
1
2
...

References

SHOWING 1-10 OF 55 REFERENCES
Effects of oestradiol valerate plus two different progestogens on serum lipids during post-menopausal replacement therapy.
TLDR
The results suggest that the cyclic addition of megestrol acetate to oestrogen therapy does not affect the serum HDL-cholesterol concentration, whereas norgestrel, which is a 19-nortestosterone derivative, causes it to decrease.
Effect of megestrol acetate on flushing and bone metabolism in post-menopausal women.
TLDR
It is concluded that progestin therapy may provide an alternative mode of treatment for post-menopausal hot flushes and bone metabolism and definitive demonstration of an effect on post- menopausal bone resorption will require a long-term study of bone density.
Metabolic Effects of Continuous Estradiol-Progestin Therapy in Postmenopausal Women
TLDR
Cholesterol metabolism was equally influenced by both progestin types, and the clinical efficacy and acceptance would decide the preparation to be advocated for women in need of hormone replacement therapy.
Effects of tibolone on serum concentrations of lipoprotein(a) in postmenopausal women.
TLDR
In terms of cardiovascular risk, the ability of tibolone to lower serum concentrations of Lp(a) may be advantageous in view of the unwanted reduction in high density lipoprotein concentrations which has previously been demonstrated in users of this steroid.
Endocrine and Metabolic Effects of Low-Dose Estrogen-Progestin Treatment in Climacteric Women
TLDR
Both norethisterone acetate and megestrol acetate seem to be suitable for estrogen-progestin combinations aimed at alleviating climacteric symptoms.
Haemostatic changes during continuous oestradiolprogestogen treatment of postmenopausal women
TLDR
Postmenopausal women with climacteric complaints were randomly allocated to receive one of four hormone replacement regimens for one year and protein C tended to decline in all treatment groups but statistically significant changes were noted only in groups A and C.
Effects of tibolone on lipoprotein(a) and HDL subfractions.
TLDR
The reduction in lipoprotein(a) levels may have a beneficial effect on cardiovascular risk, which could go some way towards balancing the potentially adverse effect on the cardiovascular system caused by the reduction in HDL cholesterol.
Effect of progestin therapy on cortical and trabecular bone: comparison with estrogen.
TLDR
The low-dose combination of Premarin plus Provera was similar in its effect on bone to that ofPremarin alone, suggesting that there may be a synergistic effect of this hormone combination on bone.
A prospective two-year study of progestin given alone in postmenopausal women: effect on lipid and metabolic parameters.
TLDR
The results show that a progestin with very low androgenic activity given alone has no influence on lipid profile and hepatic synthesis of several proteins in early postmenopausal women.
Menopause, hormone replacement therapy and cardiovascular disease: A review of haemostaseological findings
TLDR
Evidence from studies in oral contraceptive users indicates a differential effect of oestrogens on the haemostatic system that might explain for most of the observed effects.
...
1
2
3
4
5
...