Low and ultra low-dose estrogen therapy for climacteric symptom control--preliminary report.
BACKGROUND
Recent clinical trials have caused physicians to reconsider the use of hormone therapy (HT). Low-dose therapy has been proposed for those patients who tolerate standard doses poorly.


OBJECTIVE
to evaluate low-dose and ultra low-dose estrogen therapy (ET) for vasomotor symptom control.


METHODS
Thirty five healthy postmenopausal women with moderate to severe climacteric symptoms were recruited. Symptoms were evaluated at baseline and three months after the beginning of treatment by a modified Kupperman's index (KI). Endometrial thickness was assessed with pelvic ultrasonography. Patients were randomly assigned to one of these therapies: I) Esterified conjugated estrogens (ECE) 0.156 mg/day (ultra low-dose) (n = 18) or II) ECE 0.312 mg/day (low-dose) (n = 17) for 12 weeks. Statistical analysis was done with student's t test for independent and paired samples.


RESULTS
In groups I and II, the abandon rate was 33.3% and 47.0%, respectively. No differences were found among the groups in general data nor in KI. The KI at the end of the study was 47.8+/-37.9 and 48.9+/-33.2 for group I and group II, respectively, for a mean decrease of 32.1% and 37% without differences between the groups. When comparing each group separately, KI decreased in group 1, but without statistical significance. In group II there was significant decrease in KI. Endometrial thickness increased from 2.5+/-1.0 to 4.2+/-1.7 mm in group I, and from 3.5+/-1.3 to 6.0 +/-1.4 mm in group II.


CONCLUSIONS
low dose and ultra-low dose ET were useful in decreasing climacteric symptoms.
Carranza-Lira
Sebastián
S
Gynecologic Endocrinology Department, Hospital de Ginecología y Obstetricia Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, México DF. scarranzal@mexis.com
Gooch
Ana Luz Mac Gregor
AL
Velasco-Díaz
Guillermina
G
Solano
Jacqueline
J
Arzola-Paniagua
Angélica
A
D000284:Administration, Oral; D000328:Adult; D000704:Analysis of Variance; D000728:Androgens / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000378:metabolism / Q000627:therapeutic use*; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D019584:Hot Flashes / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000378:metabolism*; D016896:Treatment Outcome
D000728:Androgens; D004967:Estrogens; D004966:Estrogens, Conjugated (USP)