[HRT in post-menopausal women: endometrial histology and bleeding patterns].
BACKGROUND
In this open prospective study the correlation between bleeding patterns and endometrial histology has been evaluated in 101 postmenopausal women after 2 years of continuous sequential hormone replacement therapy (HRT).


METHODS
All patients received continuous transdermal 17-b-estradiol supplementation, 0.05 mg/daily, with cyclic progestogen for 12 days every month. The progestogen was: dydrogesterone 10 mg/daily (56 cases); nomegestrol 5 mg/daily (15 cases); MAP 10 mg/daily (15 cases); norethisterone 0.25 mg/daily (15 cases). The changes in the characteristics of bleeding pattern and endometrial biopsy were performed in 90 of 101 patients, at the 10-12th of progestogen therapy.


RESULTS
The endometrial pattern was secretory in 60 cases, proliferative in 5 and atrophic in 22. In 3 cases the endometrial histology showed a simple hyperplasia. The bleeding generally starts 2 days after the end of progestogen therapy (13th +/- 2.9 day), with a mean duration of 4 days (4 +/- 2.8); in 21 patients (~20%) the bleeding is reduced. The endometrial histological characteristics haven't any influence on the bleeding pattern.


CONCLUSIONS
In this study there was a low incidence of simple hyperplasia (3%), but the characteristics of bleeding don't permit to suspect this hyperplasia.
Istituto di Ginecologia ed Ostetricia, Cattedra di Ginecologia Endocrinologia, Università degli Studi, Palermo, Italy.
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D001706:Biopsy; D004717:Endometrium / Q000187:drug effects / Q000473:pathology; D004958:Estradiol / Q000009:adverse effects; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017698:Postmenopause; D011372:Progestins / Q000009:adverse effects; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000139:chemically induced*
D011372:Progestins; D004958:Estradiol