title: Effects of trimonthly progestin administration on the endometrium in elderly postmenopausal women who receive hormone replacement therapy: a pilot study.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of trimonthly progestin administration on the endometrium in elderly postmenopausal women who receive hormone replacement therapy.
  
  
  METHODS
  This was a prospective, randomized, double-blind, placebo-controlled study at a university teaching program. Twenty-five postmenopausal women who were >or=75 years old with an intact uterus were assigned randomly to receive conjugated equine estrogens (0.625 mg/d plus medroxyprogesterone acetate 5 mg/d for 13 days every 3 months (n = 13) or placebo (n = 12) for 9 months). At the end of the 9 months, patients in the hormone replacement therapy arm continued therapy for an additional 9 months. Statistical analysis was performed with the Student t test, the chi(2) test, and the Fisher exact test.
  
  
  RESULTS
  Transvaginal sonography was performed at baseline and at 9 and 18 months. Endometrial biopsy was performed if the endometrial thickness was >4 mm or as clinically indicated at 18 months. Patients in the hormone replacement therapy group demonstrated a significant increase in endometrial thickness between baseline (3.9 + 0.8 mm) and 9 months (8.0 + 4.8 mm). There were no cases of endometrial hyperplasia at the 18-month endometrial biopsy.
  
  
  CONCLUSIONS
  Trimonthly progestin administration in elderly postmenopausal women who receive hormone replacement therapy may be a reasonable alternative to the monthly administration of progestin in hormone replacement therapy.
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, USA.
authors.forename: Anil B
authors.initials: AB
authors.lastname: Pinto
authors.forename: Ellen F
authors.initials: EF
authors.lastname: Binder
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Kohrt
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Bronder
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Williams
mesh_terms: D000368:Aged; D001706:Biopsy; D004311:Double-Blind Method; D004714:Endometrial Hyperplasia / Q000139:chemically induced / Q000473:pathology; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology / Q000648:ultrastructure; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D010865:Pilot Projects; D010919:Placebos; D017698:Postmenopause; D045167:Progesterone Congeners / Q000008:administration & dosage*; D011446:Prospective Studies; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology
chemical_list: D010919:Placebos; D045167:Progesterone Congeners; D017258:Medroxyprogesterone Acetate