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Hormone replacement therapy: progestogen

        HORMONE REPLACEMENT THERAPY: PROGESTOGEN
To understand why, it is necessary to go back a few decades. In the 1950s and 1960s, oestrogen replacement therapy was used by women in the United States in a big way. By replacing their lost oestrogen they discovered they could be, as the phrase went, Teminine forever'. At its peak, up to 50 per cent of middle-class American menopausal women were taking oestrogen, often simply so that they would look and feel 20 years younger. Eternal youth and, of course, no more periods. Goodbye old age! Life could now be one long silver lining.
Until up popped that little black cloud. By the 1970s, doctors in the United States had begun to notice a worrying increase in the number of women on oestrogen replacement therapy who developed - and sometimes died of - cancer of the endometrium (the lining of the womb). Suddenly oestrogen therapy was getting a very bad press, and in a short space of time doctors no longer wanted to prescribe it, and women no longer wanted to take it. It seemed as if this wonderful era of eternal youth was over.
Research quickly got under way, and it was discovered that when a woman took oestrogen on its own the lining of the womb would build up each month and remain there instead being shed as a period in the normal way. Eventually, the lining of the womb would become abnormally thickened, and in some women it became cancerous. The solution was to add a form of the hormone progesterone to the oestrogen therapy every month, so that the lining of the womb did not build up, but was shed each month, as a 'period'. (After the menopause, it is not a true period as it is not triggered by ovulation, nor does it mean you are fertile and could become pregnant; it is an artificial withdrawal bleed, produced when you stop taking each monthly course of progestogen.)

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