Vaginal rings delivering progesterone and estradiol may be a new method of hormone replacement therapy.
OBJECTIVE
To determine whether a low dose of P delivered together with E(2) from a vaginal ring on a continuous schedule can prevent endometrial proliferation and yield a bleeding pattern dominated by amenorrhea.


METHODS
Longitudinal clinical study.


METHODS
Three university hospitals.


METHODS
Fifty-five women 45 to 75 years of age, not hysterectomized, with E(2) levels of <20 pg/mL and hot-flash incidence of two or more per day in the past week.


METHODS
A vaginal ring delivering approximately 150 microg/d of 17beta-E(2) and approximately 5 mg/d or approximately 9 mg/d of P used continuously for 4 and 6 months.


METHODS
Endometrial thickness, bleeding pattern, and hot flash incidence.


RESULTS
Endometrial proliferation was prevented by both P doses. Bleeding incidence decreased. In months 4, 5, and 6, 8 of 12 women had no bleeding. Incidence of hot flashes and night sweats decreased quickly and significantly.


CONCLUSIONS
A vaginal ring delivering E(2) and a low dose of P merits further study as a method for long-term hormone replacement therapy.
Maruo
Takeshi
T
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Mishell
Daniel R
DR
Ben-Chetrit
Avraham
A
Hochner-Celnikier
Drorith
D
Hamada
Anna Lissa
AL
Nash
Harold A
HA
D000328:Adult; D000339:Affect / Q000187:drug effects; D004338:Drug Combinations; D016503:Drug Delivery Systems; D004717:Endometrium / Q000473:pathology; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D011374:Progesterone / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D014592:Uterine Hemorrhage / Q000517:prevention & control; D014621:Vagina; D014623:Vaginal Diseases / Q000139:chemically induced / Q000188:drug therapy; D014666:Vasomotor System / Q000187:drug effects / Q000503:physiopathology
D004338:Drug Combinations; D011374:Progesterone; D004958:Estradiol