Endometrial response in sequential cyclic therapy assessed with associated hysteroscopy and histology.
A morphologic study was performed on the endometrium in 37 asymptomatic postmenopausal women under effects of cyclically administered oestrogens. Eighty-seven postmenopausal women were taken as control group. Medroxyprogesterone acetate (MPA), 10 mg daily, was administered in association with two types of oestrogen replacement therapy: conjugated equine oestrogens 0.625 mg (CEE) or transdermal 17 beta-oestradiol 0.05 mg (E2-TTS). Endometrial biopsies were taken under hysteroscopic control before treatment and on days 8-12 of combined therapy at the 6th month. Follow-up at 12 and 18 months was only performed in 8 and 5 patients, respectively, with transdermal 17 beta-oestradiol treatment. Various types of endometrial response were identified from atrophy to hyperplasia and secretory patterns. No atypical hyperplasia was found. All cases of simple or complex hyperplasia showed a regression after increased MPA dosage treatment (20 mg). This work is aimed at investigating the endometrial response during sequential cyclic therapy by using morphologic criteria based on hysteroscopy and histology. A large number of patients with hyperplasia can be detected with target biopsy under hysteroscopy, thus playing an important role in the management of patients during replacement therapy in research protocols.
de Cecco
L
L
Istituto di Ginecologia ed Ostetricia, Università di Genova, Ospedale, San Martino, Italy.
Gerbaldo
D
D
Fulcheri
E
E
Ferraiolo
A
A
Baracchini
P
P
Bernardini
L
L
Pescetto
G
G
D000328:Adult; D001284:Atrophy; D004714:Endometrial Hyperplasia / Q000139:chemically induced / Q000473:pathology; D004717:Endometrium / Q000187:drug effects / Q000473:pathology*; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008875:Middle Aged
D004966:Estrogens, Conjugated (USP); D004958:Estradiol; D017258:Medroxyprogesterone Acetate