title: The effects of continuous combined transdermal oestrogen-progestogen treatment on bleeding patterns and the endometrium in postmenopausal women.
abstract: Fifty postmenopausal women requiring hormone replacement therapy for the treatment of climacteric symptoms were recruited in six centers. All patients received a new combined norethisterone acetate (NETA)/oestradiol (E2)-TTS, (Estragest TTS, Ciba-Geigy Ltd), delivering 0.25 mg NETA and 50 micrograms E2 per day, continuously for 12 calendar months. Bleeding occurred in 38 (76%) of the 50 patients at any time during the 1 year treatment. The percentage of patients without bleeding increased gradually each month, from 24% in the second month to a relatively stable level of approximately 80% in month 7 and thereafter. Twenty-seven patients (54%) did not complete the whole trial period; 15 of which discontinued the treatment within the first few months due to irregular bleeding. In patients who remained in the trial, a clear decrease in the frequency and intensity of the bleeding was observed with time. Bleeding was mostly light or consisted of spotting only. None of the post-trial biopsies showed proliferation or hyperplasia of the endometrium. The treatment resulted in a substantial decrease of climacteric symptoms (Kupperman index) within 4 months and was well tolerated. It was concluded that the continuous NETA/E2-TTS treatment is an effective and safe alternative for the treatment of climacteric symptoms in selected patients.
authors.affiliation: Bosch Medicentrum, Locatie Groot Ziekengasthuis, Department of Obstetrics and Gynaecology, NL's-Hertogenbosch, The Netherlands.
authors.forename: H P
authors.initials: HP
authors.lastname: Oosterbaan
authors.forename: A H
authors.initials: AH
authors.lastname: van Buuren
authors.forename: J H
authors.initials: JH
authors.lastname: Schram
authors.forename: P J
authors.initials: PJ
authors.lastname: van Kempen
authors.forename: J M
authors.initials: JM
authors.lastname: Ubachs
authors.forename: H A
authors.initials: HA
authors.lastname: van Leusden
authors.forename: G P
authors.initials: GP
authors.lastname: Beyer
mesh_terms: D000279:Administration, Cutaneous; D002979:Climacteric / Q000187:drug effects; D004717:Endometrium / Q000187:drug effects*; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008598:Menstruation / Q000187:drug effects*; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000077563:Norethindrone Acetate; D017698:Postmenopause
chemical_list: D004958:Estradiol; D000077563:Norethindrone Acetate; D009640:Norethindrone