Maturitas
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We reviewed the published medical literature to assess the impact of the use of estrogens, with and without progestogens, on the incidence of gynecologic cancer in postmenopausal women. Long-term use of an estrogen preparation that is not accompanied by a progestogen is associated with a large increase in the risk of endometrial cancer, an association that almost certainly is a causal one. ⋯ The occurrence of other forms of gynecologic cancer appear not to be associated with the use of unopposed estrogens, though relevant data on cervical cancer are sparse. The relation of ovarian, cervical and vulvar cancer to the prior use of combined estrogen-progestogen therapy has only begun to be evaluated.
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Excessive premenopausal uterine bleeding, whether an exaggeration of catamenial loss or more severe haemorrhage, has until lately been part of traditional climacteric symptomatology, yet it is no longer so. This, and a parallel article, attempt to find out the reasons for the lapse of this symptom. The present paper concentrates on the literature of the 18-19th century, generously quoting selected sources, in an effort to define the context in which this symptom became so prominent, the explanations offered by and the approach of contemporaries to it. ⋯ When menorrhagia continued the lifestyle of these ladies was blamed. Despite all corrections, however, menorrhagia persisted. This review then examines, with varying detail, some of the writings of these two centuries, offering some glimpses into a literature otherwise not easily accessible.