title: An objective and subjective assessment of uterine blood loss in postmenopausal women on hormone replacement therapy.
abstract: OBJECTIVE
  To determine the volume of withdrawal blood loss in women taking hormone replacement therapy (HRT).
  
  
  METHODS
  Prospective randomized double blind cross-over trial.
  
  
  METHODS
  Twenty-nine postmenopausal women, with climacteric symptoms.
  
  
  METHODS
  The women were treated with cycles of 2 mg oestradiol valerate for 21 days combined with either 250 micrograms levonorgestrel or 10 mg medroxyprogesterone acetate, for the last ten days. Each woman was randomly allocated to one of the preparations and switched to the other after four months.
  
  
  METHODS
  Uterine blood loss was estimated by the alkaline haematin method. Bleeding patterns were recorded specifying the number of days with bleeding and subjective rating of the amount of blood lost.
  
  
  CONCLUSIONS
  The mean uterine blood loss was 35.2 ml and was equivalent to the normal menstrual blood loss. There was no significant difference between therapies but the women themselves considered that they bled more heavily when taking the levonorgestrel combination. The intraindividual variation in blood loss was small, independent of preparation taken, but the variation between individuals was large. Withdrawal bleeding started 2-3 days earlier when the women used the medroxyprogesterone acetate compared to the levonorgestrel formulation.
authors.affiliation: Department of Obstetrics and Gynaecology, East Hospital, University of Göteborg, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Sporrong
authors.forename: G
authors.initials: G
authors.lastname: Rybo
authors.forename: L A
authors.initials: LA
authors.lastname: Mattsson
authors.forename: G
authors.initials: G
authors.lastname: Vilbergson
authors.forename: N
authors.initials: N
authors.lastname: Crona
mesh_terms: D002979:Climacteric / Q000502:physiology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000009:adverse effects / Q000031:analogs & derivatives*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000009:adverse effects*; D008525:Medroxyprogesterone / Q000009:adverse effects / Q000031:analogs & derivatives*; D017258:Medroxyprogesterone Acetate; D008875:Middle Aged; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000139:chemically induced*
chemical_list: D004958:Estradiol; D016912:Levonorgestrel; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone