title: Can progestin be limited to every third month only in postmenopausal women taking estrogen?
abstract: We evaluated whether a progestin, added for 14 days every 3 months to estrogen replacement therapy, is capable of preventing the development of endometrial hyperplasia in postmenopausal women during a treatment period of 2 years. Postmenopausal women (263) in 10 hospitals and medical centers in Finland participated in this non-randomized prospective multicenter trial. The women received estradiol valerate 2 mg daily for 84 days and 20 mg of medroxyprogesterone acetate daily for days 71-84 followed by seven drug-free tablets. This regimen was repeated four times per year. The first year of treatment was completed by 227 (86%) women and the second year by 143 out of 146 women. The incidence of unscheduled and heavy bleedings was higher in women who were postmenopausal for less than 3 years. Endometrial biopsies demonstrated progestational response in 64% at 12 and 24 months, respectively. The 3 month regimen prevented development of endometrial hyperplasia but was not able to restore a hyperplastic endometrium to normal.
authors.affiliation: Gynecologic Center, Helsinki, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Hirvonen
authors.forename: T
authors.initials: T
authors.lastname: Salmi
authors.forename: J
authors.initials: J
authors.lastname: Puolakka
authors.forename: J
authors.initials: J
authors.lastname: Heikkinen
authors.forename: E
authors.initials: E
authors.lastname: Granfors
authors.forename: S
authors.initials: S
authors.lastname: Hulkko
authors.forename: L
authors.initials: L
authors.lastname: Mäkäräinen
authors.forename: S
authors.initials: S
authors.lastname: Nummi
authors.forename: F
authors.initials: F
authors.lastname: Pekonen
authors.forename: A M
authors.initials: AM
authors.lastname: Rautio
mesh_terms: D000328:Adult; D000368:Aged; D002979:Climacteric / Q000502:physiology; D004334:Drug Administration Schedule; D004714:Endometrial Hyperplasia / Q000517:prevention & control*; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008599:Menstruation Disturbances / Q000453:epidemiology; D008875:Middle Aged; D017060:Patient Satisfaction; D017698:Postmenopause; D011446:Prospective Studies; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D004958:Estradiol; D017258:Medroxyprogesterone Acetate