Continuous intrauterine compared with cyclic oral progestin administration in perimenopausal HRT.
OBJECTIVE
Two hormone replacement therapy (HRT) regimens of combined oral estradiol with either continuous intrauterine or cyclic oral progestin were compared for 2 years.


METHODS
200 perimenopausal women randomly received an intrauterine system with continuous levonorgestrel release (20 microg/24 h) combined with oral estradiol (2 mg daily), or a cyclic oral regimen of norethisterone acetate (1 mg on day 13-22) and estradiol (days 1-21; 2 mg, days 22-28; 1 mg). Efficacy on endometrial protection, vaginal bleeding patterns, blood loss and practical use were compared during 26 cycles.


RESULTS
Endometrial protection was adequate in both regimens. The cyclic regimen induced a more regular bleeding pattern. The continuous local administration induced a reduction in bleeding (P=0.001) with an initial period of prolonged and frequent bleeding. 38% became amenorrhoeic. Women found both regimens acceptable.


CONCLUSIONS
Continuous intrauterine Levonorgestrel administration by using an intrauterine system can well be recommended for use in combination with oestrogen replacement therapy in perimenopausal women.
Boon
Janine
J
Department of Obstetrics and Gynecology, Diakonessenhuis, Bosboomstraat 1, 3582 KE, Utrecht, Netherlands. janineboon@compuserve.com
Scholten
Piet C
PC
Oldenhave
Anna
A
Heintz
A Peter M
AP
D000284:Administration, Oral; D002979:Climacteric; D004338:Drug Combinations; D004958:Estradiol / Q000008:administration & dosage; D004964:Estriol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010349:Patient Compliance
D004338:Drug Combinations; C044003:estradiol, estriol drug combination; D004958:Estradiol; D016912:Levonorgestrel; C032040:Trisequens; D004964:Estriol; D009640:Norethindrone