title: Endometrial effects of transdermal estradiol/norethisterone acetate.
abstract: The efficacy of transdermal norethisterone acetate in sequence with transdermal estradiol has been investigated in a multicenter study of 136 post-menopausal women to determine the incidence of endometrial hyperplasia, the effects on the vaginal cytology and the control of bleeding. Treatment consisted of 12 cycles of 4 weeks each (2 weeks estradiol 50 micrograms/day followed by 2 weeks of a new combined patch delivering norethisterone acetate 0.25 mg/day and estradiol 50 micrograms/day). Endometrial histology was assessed by two pathologists. Of the 136 pre-treatment biopsies 89% provided no material, an inadequate sample or an inactive (atrophic or non-secretory) endometrium. Of the post-treatment biopsies from 110 women who completed the study: 65% showed secretory, 3% proliferative and 24% inadequate material or inactive endometrium. Hyperplasia was found in two biopsies (2%); in one of these focal atypical hyperplasia was agreed by both pathologists, in another a hyperplastic endometrial polyp was diagnosed by one pathologist. The bleeding was regular in 80% of the 1195 cycles and irregular in 11%. No bleeding occurred in 9% of the cycles. Vaginal cytology showed a significant shift towards increased maturation during treatment.
authors.affiliation: Dept. of Obstetrics & Gynecology, University Hospital, Linköping, Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Lindgren
authors.forename: B
authors.initials: B
authors.lastname: Risberg
authors.forename: M
authors.initials: M
authors.lastname: Hammar
authors.forename: G
authors.initials: G
authors.lastname: Berg
authors.forename: J
authors.initials: J
authors.lastname: Pryse-Davies
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D004714:Endometrial Hyperplasia / Q000517:prevention & control; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077563:Norethindrone Acetate; D045167:Progesterone Congeners / Q000008:administration & dosage*; D014592:Uterine Hemorrhage / Q000517:prevention & control; D014621:Vagina / Q000187:drug effects / Q000473:pathology
chemical_list: D045167:Progesterone Congeners; D004958:Estradiol; D000077563:Norethindrone Acetate; D009640:Norethindrone