title: A scheme of combined oral contraceptives for women more than 40 years old.
abstract: OBJECTIVE
  To study whether the addition of estrogen to the 7 hormone-free days of a combined oral contraceptive (OC) cycle improves the symptomatology in perimenopausal women with climacteric complaints.
  
  
  METHODS
  A total of 56 women in their forties presenting with mood disorders and/or hot flashes were included in this randomized double-blind study. Symptoms were evaluated using the Greene test. Subjects were allocated into two groups: 23 women received an OC containing 20 microg of ethinyl-estradiol and 150 mg of desogestrel for 21 days and then 7 placebo tablets (placebo group); the other 33 women received 21 tablets with the same hormone combination, followed by 2 placebo tablets and 5 ethinyl-estradiol tablets of 10 microg each (estrogen group). After three cycles, symptoms were reassessed.
  
  
  RESULTS
  Symptoms were similar in the two groups at the start of the study. Three months later, vasomotor symptoms in the placebo group dropped from 3.3 +/- 1.7 to 1.7 +/- 1.8, and in the estrogen group, from 3.0 +/- 1.7 to 0.7 +/- 0.9 (p < 0.04). Similarly, symptoms of depression fell from 8.8 +/- 4.0 to 6.7 +/- 3.9 in the placebo group and from 10.3 +/- 3.5 to 3.8 +/- 2.9 in the estrogen group (p < 0.002). Somatic symptoms fell with placebo from 10.9 +/- 5.3 to 7.4 +/- 5.4, and with estrogen, from 9.7 +/- 4.9 to 4.0 +/- 2.5 (p < 0.03). Sexual dysfunction as measured by the Greene Scale (loss of sexual interest) also improved more in women who received additional estrogen: 2.0 +/- 0.9 to 0.5 +/- 0.9 vs. 1.8 +/- 1.2 to 1.2 +/- 1.2, p < 0.03. Anxiety symptoms improved in both groups but without any significant difference between them.
  
  
  CONCLUSIONS
  Adding 5 days of estrogen to the classic contraceptive scheme improves the climacteric symptoms of perimenopausal women who use OCs.
authors.affiliation: Fundación Prosam, Santiago de Chile, Hospital Clínic, Universitat de Barcelona, Spain.
authors.forename: J E
authors.initials: JE
authors.lastname: Blümel
authors.forename: C
authors.initials: C
authors.lastname: Castelo-Branco
authors.forename: L
authors.initials: L
authors.lastname: Binfa
authors.forename: R
authors.initials: R
authors.lastname: Aparicio
authors.forename: L
authors.initials: L
authors.lastname: Mamani
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000188:drug therapy* / Q000209:etiology; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D017135:Desogestrel / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D045166:Estradiol Congeners / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D010298:Parity / Q000187:drug effects; D017697:Premenopause / Q000187:drug effects* / Q000502:physiology / Q000523:psychology; D045167:Progesterone Congeners / Q000627:therapeutic use*; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D003277:Contraceptives, Oral, Combined; D045166:Estradiol Congeners; D045167:Progesterone Congeners; D004997:Ethinyl Estradiol; D017135:Desogestrel