Prolonged effects of a novel, low-dosage continuous progestin-cyclic estrogen replacement program in postmenopausal women.
OBJECTIVE
Our objective was to ascertain long-term tolerability and effects of a novel, low-dosage continuous progestin-cyclic estrogen regimen on vasomotor flushing, vaginal bleeding patterns, bone density, and plasma lipoprotein lipids.


METHODS
Eighteen postmenopausal women with climacteric symptoms received low doses of dl-norgestrel (0.075 mg/day) continuously and 17 beta-estradiol (1 mg/day) intermittently (25 of 28 days) for 3 years. The results were compared with baseline values.


RESULTS
The hormonal regimen was well tolerated. Vaginal bleeding, vaginal spotting, and vasomotor flushing occurred in only 0.4%, 4.2%, and 7.7% of cycles, respectively. Bone density was stable. Mean fasting plasma total cholesterol concentration fell 19%, low-density lipoprotein cholesterol 23%, high-density lipoprotein cholesterol 13%, and triglycerides 31% (p less than 0.01) over the 3-year period, while the ratios of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol decreased by 14% and 10%, respectively.


CONCLUSIONS
Long-term compliance with female hormonal replacement is feasible once vaginal bleeding is essentially eliminated, allowing for potentially better prophylaxis against coronary heart disease, osteoporosis, endometrial cancer, and stroke.
Plunkett
E R
ER
Department of Gynaecology and Medicine, University Hospital, London, Ontario, Canada.
Wolfe
B M
BM
D001794:Blood Pressure; D015519:Bone Density; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002979:Climacteric; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009644:Norgestrel / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood; D014592:Uterine Hemorrhage
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D009644:Norgestrel; D004958:Estradiol; D002784:Cholesterol