title: Bleeding pattern and climacteric symptoms during different sequential combined HRT regimens in current use.
abstract: Four sequential combined oestrogen and progestogen regimens were compared in terms of bleeding pattern and relief of climacteric symptoms. Treatment was with either 2 mg 17 beta-oestradiol with 1 mg norethisterone acetate [E2 + NETA]; 2 mg oestradiol valerate with 75 micrograms levonorgestrel [E2V + LNG]; 2 mg oestradiol valerate with 10 mg medroxyprogesterone acetate [E2V + MPA]; or 1.5 mg 17 beta-oestradiol with 150 micrograms desogestrel [E2 + DG]. A placebo-controlled study lasting 12-24 months was completed by 143 healthy early postmenopausal women. Bleeding lengths were not substantially different; in all regimens the majority of women were bleeding for 3-6 days. Bleeding onset showed differences when related to the 11th day of progestogen addition; in the regimen with E2V + LNG, 21% of the women women were bleeding before the 11th day of progestogen addition 26% on, and 53% after that day. In the regimen with E2V + MPA, 56% of the women were bleeding before the 11th day, 28% on, and 17% after that day, whereas in the regimen with E2 + DG, 15% of the women were bleeding before the 11th day, 5% on, and 80% after that day. All regimens reduced climacteric symptoms to the same extent. Breast tenderness occurred in all the regimens, except in the E2 + DG. Conclusively, the differences between the responses to treatment were not conspicuous. However, our data indicate that one regimen (E2 + DG) resulted in optimal bleeding control, optimal effect on climacteric symptoms, and no production of breast tenderness.
authors.affiliation: Center for Clinical & Basic Research, Ballerup, Denmark.
authors.forename: U
authors.initials: U
authors.lastname: Marslew
authors.forename: N
authors.initials: N
authors.lastname: Munk-Nielsen
authors.forename: L
authors.initials: L
authors.lastname: Nilas
authors.forename: B J
authors.initials: BJ
authors.lastname: Riis
authors.forename: C
authors.initials: C
authors.lastname: Christiansen
mesh_terms: D001940:Breast / Q000187:drug effects; D002979:Climacteric / Q000187:drug effects*; D017135:Desogestrel / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000031:analogs & derivatives / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use; D005260:Female; D005483:Flushing / Q000517:prevention & control; D006801:Humans; D016912:Levonorgestrel / Q000627:therapeutic use; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D008597:Menstrual Cycle / Q000187:drug effects; D008875:Middle Aged; D009640:Norethindrone / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077563:Norethindrone Acetate; D045167:Progesterone Congeners / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; D004958:Estradiol; D016912:Levonorgestrel; D017135:Desogestrel; D000077563:Norethindrone Acetate; D017258:Medroxyprogesterone Acetate; D009640:Norethindrone