Changes in the withdrawal bleeding pattern and endometrial histology during 17 beta-estradiol-dydrogesterone therapy in postmenopausal women: a 2 year prospective study.
OBJECTIVE
To describe changes in the withdrawal bleeding pattern and endometrial histology during a sequential 17 beta-estradiol-dydrogesterone regimen in postmenopausal women.


METHODS
Open-label, non-comparative, prospective study.


METHODS
Gynecological outpatient department of a university hospital.


METHODS
Twenty-seven healthy non-hysterectomized postmenopausal women.


METHODS
Continuous micronized 17 beta-estradiol supplementation, 2 mg daily, and cyclic administration of dydrogesterone, 10 mg daily for the first half of each 28 day treatment cycle.


METHODS
Changes in the characteristics of the withdrawal bleeding pattern and the endometrial biopsy histology during 2 years of treatment.


RESULTS
The initial withdrawal bleeding was comparable to normal menstruation with respect to amount and duration. During the 2 years of treatment the bleeding showed a significant tendency to become shorter with less blood loss. This was mainly the result of the decrease (P < 0.001) in the number of days per cycle with bleeding grade II (normal menstruation). None of the women developed endometrial hyperplasia, and in almost all women the given hormone replacement therapy regimen induced secretory or atrophic changes of the endometrium.


CONCLUSIONS
This sequential 17 beta-estradiol-dydrogesterone regimen can be regarded as safe with respect to the prevention of endometrial disease and appeared to foster patient compliance.
van der Mooren
M J
MJ
Department of Obstetrics and Gynecology, University Hospital Nijmegen Sint Radboud, Nijmegen, The Netherlands.
Hanselaar
A G
AG
Borm
G F
GF
Rolland
R
R
D001706:Biopsy; D002979:Climacteric / Q000187:drug effects* / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004394:Dydrogesterone / Q000008:administration & dosage / Q000009:adverse effects*; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008598:Menstruation / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D011446:Prospective Studies
D004958:Estradiol; D004394:Dydrogesterone