title: The long-term effects of estradiol implant therapy for the treatment of premenstrual syndrome.
abstract: Fifty patients receiving estradiol implants for long-term treatment of premenstrual syndrome were studied over 5.6 years (range 2-8 years). There was a continued beneficial response to treatment in all symptoms, varying between 74% for bloating and 96% for depression. Menstrual cycle control improved in 31 patients and periods were less painful in 30 patients. Cyclical progestogenic symptoms occurred in 58% of patients. These were partially relieved by alterations in dose, type and duration of progestogen treatment but in 7 patients the symptoms remained severe. Eight patients had a hysterectomy during treatment; 5 for continuing progestogenic symptoms, 1 for prolapse and 2 for prolonged menstrual bleeding despite adequate progestogen therapy. Attempts to reduce the dose of progestogen led to cystic hyperplasia in 4 patients. This was treated by hysterectomy in 2 patients and corrected with two 21-day courses of progestogen in the other 2. Uterine enlargement with a mean weight of 133 g (125-145 g) associated with myometrial hypertrophy occurred in all 8 hysterectomy patients. There were no complications form venous thrombosis, pulmonary embolus, breast disease or atypical endometrial hyperplasia.
authors.affiliation: Dulwich Hospital, London, UK.
authors.forename: N R
authors.initials: NR
authors.lastname: Watson
authors.forename: J W
authors.initials: JW
authors.lastname: Studd
authors.forename: M
authors.initials: M
authors.lastname: Savvas
authors.forename: R J
authors.initials: RJ
authors.lastname: Baber
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004343:Drug Implants; D004717:Endometrium / Q000473:pathology; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009929:Organ Size; D011293:Premenstrual Syndrome / Q000188:drug therapy*; D013739:Testosterone / Q000097:blood; D014599:Uterus / Q000033:anatomy & histology / Q000187:drug effects / Q000601:surgery
chemical_list: D004343:Drug Implants; D013739:Testosterone; D004958:Estradiol; D005640:Follicle Stimulating Hormone