title: Potential health benefits of continuous LNG-IUS combined with parenteral ERT for seamless menopausal transition and beyond--a commentary based on clinical experience.
abstract: OBJECTIVE
  To comment on the acceptability and potential health benefits of the continuous use of the levonorgestrel-releasing intrauterine system (LNG-IUS), combined with estrogen substitution, for seamless transition through the menopause, in women with climacteric symptoms.
  
  
  METHODS
  Evaluation of the recent hormone replacement therapy literature and the acceptability of the combined parenteral estrogen and intrauterine LNG-IUS regimen in a group of approximately 100 women, above 48 years of age, using LNG-IUS for contraception, who developed climacteric symptoms requiring estrogen substitution.
  
  
  METHODS
  acceptability and continued use of the method for the treatment of climacteric symptoms and for prevention.
  
  
  RESULTS
  The combination of intrauterine progestogen delivery to suppress the endometrium, in combination with systemic estrogen, is highly acceptable resulting in a high continuation of use due to the absence of side effects and erratic bleeding in the large majority of women.
  
  
  CONCLUSIONS
  The study suggests that parenteral estrogen replacement therapy combined with intrauterine progestogen delivery for endometrial suppression in the perimenopause is highly practical and beneficial, providing enhanced quality of life. There are strong arguments to categorize the regimen as probably the most effective, safest and best accepted route resulting in high patient compliance as well as potentially providing maximal benefits for peri- and postmenopausal women.
authors: Contrel Drug Delivery Research, Ghent, Belgium. d.wildemeersch@skynet.be
authors: Dirk
authors: D
authors: Wildemeersch
mesh_terms: D000368:Aged; D002979:Climacteric / Q000187:drug effects / Q000502:physiology; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D008593:Menopause / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D004958:Estradiol; D016912:Levonorgestrel