Women who take oral hormone replacement therapy (HRT) are advised to talk to their doctor if they also start using the weight loss Jab Mounjaro, in the midst of ensuring that they can run a higher risk of womb cancer.
In the meantime, there are fears that women get Mounjaro online – instead of through their doctor – will not be aware of the potential risk.
HRT offers estrogen to alleviate the symptoms of the menopause such as hot flashes, a low mood and reduced sex -drive.
Because estrogen makes the lining of the uterus thicker, which can increase the risk that it will be cancer -like, it is combined with progesterone or a progestogenic (a synthetic version of progesterone) in HST to keep the lining thin.
Many women take estrogen in the form of a rubbing or skin plaster-in place of oral progestogenic in the form of a tablet that must be absorbed in the bloodstream through the stomach lining.
The care is that a reduction in the absorption of oral progesterone or progestogenic as a result of taking Mounjaro could increase the risk of uterus cancer.
New guidelines of the British Menopause Society warn that Mounjaro could disrupt with the recording of oral forms of HRT
And there is another risk for women who take the oral contraceptive pill and the weight loss Jabs: an unplanned pregnancy.
The new obesity-fighting drugs contain Semaglutide (brand names Wegovy and Ozempic) or Tirzepatide (Mounjaro) -This works by delaying digestive system (‘gastricmolding’), and can cause stomach symptoms such as nausea and vomiting, which can reduce the absorption of oral medication.
Now new guidelines from the British Menopause Society (BMS) warn Mounjaro could interfere with the recording of oral forms of HRT.
Although the cancer risk is only ‘theoretical’, doctors should consider increasing the dose of oral progestogenic of a woman when she first starts on Mounjaro, says Professor Annice Mukherjee, a consultant endocrinologist at Spire Healthcare in Manchester, who helped write the new guidelines.
This is when the effect on the absorption of oral pills is greatest (according to the Mounjaro patient folder).
The dose of progestogeneous should then temporarily increase every time the dose of weight loss medicine increases to compensate for the extra effect on absorption. The BMS guidelines are aimed at women who take oral progestogenic in addition to estrogen in gel or patch shape.
(Under those on combined oral contraceptives, the absorption of both estrogen and progestogenic is reduced and women who have had a hysterectomy are not included in the new guidelines because they only take estrogen.)
Professor Mukherjee said Good Health that the reduction of progestogen ‘is a special problem for women who live with obesity and diabetes [the conditions the new jabs are designed to treat] Because they already have an increased risk of uterus thickening and cancer ‘.
‘Patients who are suitable for Mounjaro must generally be offered transdermal estrogen [eg gels or patches]who are usually considered safe in women with diabetes and obesity, and not oral estrogen, who can increase the risk of blood clots. ‘
An alternative to increasing the dose of oral progesterone is to switch to a non-oral form of progesterone, such as the Mirena coil implant, or a combined estrogen-progestogenic patch, Dr. Alice Scott, a specialist in the menopause at Essex-particululous doctors.
Doctors should consider lifting a woman’s oral progestogenic dose when she starts Mounjaro, says Professor Annice Mukherjee, an adviser -endocrinologist
Another potential consequence of reduced absorption of progestogenic is unexpected bleeding and spotting. Dr. Scott, who has treated patients with the problem in her clinic, says she has seen this in women who bought slim injections online without the right medical guidance.
“My concern is that women are so easy to get these medicines online, women do not have enough consultation before they obtain them,” she says. ‘This means that advice on the effect of these drugs on other oral medicines is not given.
‘There are indications that these drugs for weight loss in general [ie not only Mounjaro] Can also reduce the effectiveness of oral contraceptive pills that can increase the risk of pregnancy, so it is important for women who use it to discuss this with their doctor.
“The problem is that many people do not make their doctors public that they are on Mounjaro or other Jabs for weight loss, so it is important that care providers immediately ask patients from their medication assessments.”
Novo Nordisk, who makes Ozempic and Wegovy, recommends that the medicines are being taken under medical supervision.
A spokesperson added: ‘No clinical tests have specifically looked at how HRTs and semaglutide work on each other. In other pharmacological studies, Semaglutide had no influence on the absorption of oral medicines in a clinically relevant extent. ‘
But they added: “Since Semaglutide causes a delay of gastric emptying, it may have an impact on the absorption of oral medication taken next to it, as such, caution must be exercised when using oral medicines in addition to semaglutide and must be discussed with your care provider.”
Mounjaro manufacturer Eli Lilly said that information to healthcare providers is explained that ‘tirzepatide stomachs empties and therefore has the possibility to influence the absorption rate of simultaneously oral medicinal products.’
“This effect is the most pronounced at the time of the initiation of treatment with tirzepatide,” a spokesperson added.
“Patients must consult their doctor or other care provider with regard to the correct treatment options or to report side effects they can experience.”
#Mounjaro #HST #increase #risk #uterine #cancer #people #obesity #diabetes #danger #special #report #Julie #Cook