Mr Jeevan Seekhon1,2, Dr Talat Uppal1,2,3
1Women's Health Road Pty Ltd, Frenchs Forest, Australia, 2Macquarie University, Macquarie, Australia, 3Western Sydney University, Western Sydney, Australia
Biography:
Dr Talat Uppal is an Obstetrician & Gynaecologist who works at Macquarie University and Hornsby Ku-ring-gai Hospitals as a Visiting Medical Officer.
She is the Director of Women’s Health Road (an RACGP accredited practice) and has set up an innovative integrated multidisciplinary model.
Her niche interest is the management of women with abnormal menstrual bleeding (AUB) and have founded Australia’s first AUB management Hub a hybrid, digitally enhanced model of care.
She has also organised a co-located charity that has a bleed better initiative.
She is a Clinical Senior lecturer in Obstetrics and Gynaecology at Macquarie University.
Abstract:
This systematic review and meta-analysis evaluates the risk of endometrial hyperplasia and carcinoma associated with different menopausal hormone therapy (MHT) regimens in peri- and postmenopausal women with an intact uterus. A comprehensive search of controlled clinical trials from 2000 to 2024 identified 26 studies encompassing over 36,000 participants. The analysis focused on comparing sequential combined (SC) and continuous combined (CC) MHT regimens, with additional consideration of progestin type, dose, and route of administration. Results demonstrate that CC regimens, particularly those using daily synthetic progestins such as medroxyprogesterone acetate, norethisterone acetate, or drospirenone, provide the lowest risk of endometrial hyperplasia and carcinoma. The overall incidence of endometrial carcinoma was low and comparable between SC and CC regimens. These findings underscore the importance of both regimen structure and progestin characteristics in minimizing endometrial risk. Future research should address the comparative safety of bioidentical versus synthetic progestins and non-oral delivery routes.
We will also cover management of unscheduled bleeding on MHT including comparison between the British and Australian Menopause society guidelines/recommendations.