Women's expectations and acceptance of cyclic induced HRT bleeds.
OBJECTIVE
To assess women's expectations and acceptance of cyclic induced HRT bleeds before and after their participation in a 1-year study and to compare the impact of these cyclic bleeds with that of previous menstrual bleeds.


METHODS
A structured bleeding questionnaire was used to gather information: at baseline (before screening) on previous menstrual cycle patterns and accompanying discomfort, oral contraceptive use, current smoking habits, parity and the acceptance, preferences and expectations regarding HRT-induced bleeds. Women with amenorrhoea of 6 months or more and FSH levels (35 IU/l then received a daily oral dose of 1 mg 17 beta-oestradiol on days 1-28, combined with either 5 or 10 mg dydrogesterone on days 15-28, for 12 months (13 cycles of 28 days). At the end of their participation, women were again interviewed about their actual experiences with HRT-induced bleeds.


RESULTS
One hundred and fifty-four women completed the questionnaire at baseline and 141 (including 131 completers) responded at the end. At baseline, 82% indicated to be pleased that menstruation had ceased, but nevertheless 94% stated that return of periods would be acceptable. At the end, 91% still found the occurrence of cyclic bleeds acceptable; this mostly depended on the perceived benefits outweighing the discomfort. Of the women who actually experienced bleeds (101) 60% regarded discomfort and blood loss less than during their previous menstrual cycles. A regular cycle pattern was considered more important than modest flow and short duration.


CONCLUSIONS
In contrast to other studies, the acceptance of renewed vaginal bleeds in our study was high.
van de Weijer
P H
PH
Department of Obstetrics and Gynaecology, Menopause Research Project Ageing Women, Free University Hospital, Amsterdam, The Netherlands. phmvdw@gironet.nl
Barentsen
R
R
Kenemans
P
P
D000328:Adult; D001294:Attitude to Health; D004311:Double-Blind Method; D004394:Dydrogesterone / Q000627:therapeutic use; D004958:Estradiol / Q000627:therapeutic use; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D008597:Menstrual Cycle; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014592:Uterine Hemorrhage / Q000139:chemically induced*
D004958:Estradiol; D004394:Dydrogesterone