Three cases of endometrial cancer associated with “bioidentical” hormone replacement therapy

John A Eden, Neville F Hacker and Michael Fortune
Med J Aust 2007; 187 (4): 244-245.

We describe three women who developed endometrial cancer after taking “bioidentical” hormone replacement therapy (HRT) to relieve menopausal symptoms. Although pharmaceutical HRT is a well established and tested therapy, little is known about the quality control, safety and efficacy of bioidentical HRT. Women should be advised to avoid bioidentical HRT, and those who continue to use it should receive regular endometrial surveillance.

A 71-year-old non-diabetic woman had been on some form of hormone replacement therapy (HRT) since the age of 49 years. She took oral oestrone sulfate 1.25 mg daily and medroxyprogesterone acetate 10 mg for at least 10 days a month for 8 years. For the next 2 years, she used a 3.2% compounded topical progesterone cream (at a daily dose of “one level spoonful”). In December 1997, she had some irregular vaginal bleeding, which was investigated by diagnostic hysteroscopy and curettage. The tissue diagnosis was atrophic endometritis.

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  • John A Eden1,2
  • Neville F Hacker2
  • Michael Fortune3

  • 1 University of New South Wales, Sydney, NSW.
  • 2 Royal Hospital for Women, Sydney, NSW.
  • 3 Prince of Wales Private Hospital, Sydney, NSW.


Competing interests:

John Eden is a consultant for Wyeth, AstraZeneca, Arkopharma, and Lawley Pharmaceuticals.

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