High-dose estrogen therapy

High-dose estrogen therapy (HDE) is a type of hormone therapy in which high doses of estrogens are given. When given in combination with a high dose of progestogen, it has been referred to as pseudopregnancy. It is called this because the estrogen and progestogen levels achieved are in the range of the very high levels of these hormones that occur during pregnancy. HDE and pseudopregnancy have been used in medicine for a number of hormone-dependent indications, such as breast cancer, prostate cancer, and endometriosis, among others. Both natural or bioidentical estrogens and synthetic estrogens have been used and both oral and parenteral routes may be used. HDE and/or pseudopregnancy have been used in clinical medicine for the following indications: Estrogen receptor-positive breast cancer in women As a means of androgen deprivation therapy for prostate cancer and benign prostatic hyperplasia in men In combination with progestins for endometriosis in women. Although initially used alone, progestins were added in the 1960s and 1970s. In addition, the estrogen diethylstilbestrol is an example of medical reversal as it increases the risk of endometriosis in the treated women and in their female children. Osteopenia and osteoporosis in women Prevention of tall stature in tall adolescent girls Suppression of () levels in acromegaly and gigantism As a component of hormone therapy for transgender women to achieve feminization and suppress androgens Breast hypoplasia or as a means of hormonal breast enhancement in women Uterine hypoplasia in women Premenstrual syndrome and premenstrual dysphoric disorder in women Postpartum depression and psychosis in women The nonsteroidal estrogen diethylstilbestrol as well as other stilbestrols were previously used to support pregnancy and reduce the risk of miscarriage, but subsequent research found that diethylstilbestrol was both ineffective and teratogenic. HDE should be combined with a progestogen in women with an intact uterus as unopposed estrogen, particularly at high dosages, increases the risk of endometrial hyperplasia and endometrial cancer.