Norethindrone acetate and estradiol-induced endometrial hyperplasia

Robert J. Kurman, Juan Carlos Félix, David F. Archer, Nayan Nanavati, Joan Carles Arce, Dean L. Mover

Research output: Contribution to journalArticlepeer-review


Objective: To identify the lowest effective continuous dose of norethindrone acetate that significantly reduces 12-month incidence of endometrial hyperplasia associated with unopposed 17-estradiol (E2), 1 mg. Methods: In a double-masked, randomized, multicenter study, 1176 healthy postmenopausal women 45 years of age or older without evidence of endometrial abnormalities were given 12 months of treatment with unopposed E2,1 mg, or continuous-combined regimens of E2,1 mg, and norethindrone acetate, 0.1 mg, 0.25 mg, or 0.5 mg. Endometrial histology was evaluated at the end of the treatment period. Results: Continuous-combined E2-norethindrone acetate regimens significantly reduced 12-month incidence of endometrial hyperplasia compared with unopposed E21 mg (P < .001). Endometrial hyperplasia occurred in 14.6% of women treated with unopposed E2 1 mg, whereas in all continuouscombined groups, the rate decreased to less than 1%. Among patients who received E2-norethindrone acetate 0.1 mg, incidence was 0.8%; among those who received 0.25 mg and 0.5 mg, it was 0.4%. Conclusion: Continuous norethindrone acetate at doses as low as 0.1 mg combined with E2 1 mg effectively negated risk for endometrial hyperplasia associated with unopposed E21 mg, at least for the first year of therapy.

Original languageEnglish (US)
Pages (from-to)373-379
Number of pages7
JournalObstetrics and gynecology
Issue number3
StatePublished - Aug 23 2000

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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