title: Endocrine effects in Asian postmenopausal women, treated with SH D 461 M and Prempak-C.
abstract: We reported the results of a randomized cross-over study comparing SH D 461 M (Climen) and Prempak-C in 38 postmenopausal women who were established users of hormone replacement therapy (HRT). Climen contains 11 tablets of 2 mg estradiol valerate (EV), and 10 tablets with 2 mg EV plus 1 mg of cyproterone acetate. Prempak-C, on the other hand, is a regimen consisting of 28 tablets of 0.625 mg conjugated equine estrogens (CEE); the last 12 tablets are taken together with 0.15 mg of norgestrel (NG) tablets. Patients in Sequence I started with Climen for 6 months and then crossed-over to Prempak-C, for the next 6 months. Patients in Sequence II followed the reverse order. Following Climen treatment, significantly higher levels (P < 0.05, t-test) of sex hormone binding globulin (SHBG) and estradiol, when compared to Prempak-C treated subjects, were noted. No significant differences in follicle stimulating hormone (FSH), corticosteroid binding globulin (CBG), renin angiotensinogen, angiotensin-I and aldosterone levels between the two treatment regimens were noted. While both regimens were effective in reducing menopausal symptoms, none of the regimens could eliminate all symptoms completely. Treatment with Climen appeared to result in less frequent occurrences of some symptoms. During periods of no estrogen (only true for Climen) as well as periods of maximum P and E, subjects on Climen had significantly lower incidence of some of the symptoms (backache, lack of concentration, lethargy and swelling) when compared to those on Prempak-C.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Obstetrics and Gynaecology, National University of Singapore, National University Hospital, Kent Ridge.
authors.forename: H H
authors.initials: HH
authors.lastname: Goh
authors.forename: T G
authors.initials: TG
authors.lastname: McCarthy
authors.forename: V
authors.initials: V
authors.lastname: Dramusic
authors.forename: A
authors.initials: A
authors.lastname: Costales
authors.forename: W
authors.initials: W
authors.lastname: Junge
authors.forename: S S
authors.initials: SS
authors.lastname: Ratnam
mesh_terms: D000328:Adult; D001208:Asia / Q000208:ethnology; D002979:Climacteric / Q000097:blood*; D018592:Cross-Over Studies; D017373:Cyproterone Acetate / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood*; D004967:Estrogens / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009644:Norgestrel / Q000008:administration & dosage*; D017698:Postmenopause / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000187:drug effects / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D004967:Estrogens; D012738:Sex Hormone-Binding Globulin; D009644:Norgestrel; D017373:Cyproterone Acetate; D004958:Estradiol