title: Two routes of hormonal replacement therapy in symptomatic menopausal women after kidney transplantation.
abstract: OBJECTIVE
  The assessment of efficacy and safety of two regimens of hormonal replacement therapy (HRT) in women after kidney transplantation with climacteric symptoms.
  
  
  METHODS
  Combined transdermal or transdermal-oral hormonal replacement therapy was administered to 86 kidney-transplanted women, aged 31-52 years, with moderate to severe climacteric symptoms in years 1995-2005. The patients underwent follow-up examinations one, three and six months after onset of the therapy and every four months subsequently. Blood pressure, body weight, sex hormone profile, serum parameters of both kidney and liver function, endometrial image in transvaginal sonography and reduction of climacteric symptoms were assessed.
  
  
  RESULTS
  The mean time of the therapy was 5.6 years for transdermal-oral regimen (54 patients) and 4.7 years for transdermal regimen (32 patients). Most patients reported reduction of climacteric symptoms and improved life quality after 6 months of HRT. 28% of women discontinued therapy for medical indications, most often due to significant deterioration of liver function. One case of profound vein thrombosis was noted. 21% of women decided to discontinue therapy after the results of the WHI trial had been published.
  
  
  CONCLUSIONS
  Hormonal replacement therapy is effective in climacteric symptoms relief and improvement of life quality in kidney transplanted women. Higher rate of side effects observed in that group of patients contributes to the need for frequent, attentive surveillance. Further studies should be conducted to establish the optimal doses and routes of administration of HRT as well as to assess the range of necessary follow-up examinations.
authors.affiliation: 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
authors.forename: Bronisława
authors.initials: B
authors.lastname: Pietrzak
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Wielgos
authors.forename: Pawel
authors.initials: P
authors.lastname: Kaminski
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Bobrowska
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000379:methods*; D006728:Hormones / Q000008:administration & dosage; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008234:Lynestrenol / Q000008:administration & dosage; D008593:Menopause / Q000187:drug effects / Q000502:physiology*; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D006728:Hormones; D004958:Estradiol; D008234:Lynestrenol