Progesterone and endometrial cancer

Best Pract Res Clin Obstet Gynaecol. 2020 Nov:69:95-107. doi: 10.1016/j.bpobgyn.2020.05.003. Epub 2020 Jun 9.


It is well established that unopposed estrogen, either endogenous or therapeutic, can induce endometrial hyperplasia and potentially endometrial cancer (EC). Anovulatory cycles, obesity, and insulin resistance are major risk factors for EC. Progestogen (progesterone and progestin), including levonorgestrel intrauterine device, are able to prevent or to treat hyperplasia, atypical hyperplasia, and even well-differentiated EC, as presented in this review. During menopausal hormone therapy, progestogens protect the endometrium against the proliferative effects of estrogens in women with a uterus. Whereas, recent epidemiologic data suggest that micronized progesterone (MP) is apparently safer for the breast, it could be less efficient than synthetic progestin on the endometrium. However, several studies from biopsies during treatment with MP do not show any increased risk of hyperplasia. Lack of compliance could explain the results on EC.

Keywords: Hyperplasia; Menopause hormone therapy; Micronized progesterone; POCS.

Publication types

  • Review

MeSH terms

  • Endometrial Hyperplasia* / chemically induced
  • Endometrial Neoplasms* / epidemiology
  • Endometrium
  • Estrogen Replacement Therapy / adverse effects
  • Estrogens
  • Female
  • Humans
  • Progesterone / adverse effects
  • Progestins / adverse effects


  • Estrogens
  • Progestins
  • Progesterone