Combined oral hormone replacement therapy formulations.

Area of Science:

• Women's Health
• Endocrinology
• Pharmacology

Background:

• Clinicians face challenges in managing women's contraceptive needs and transitioning them to menopausal hormone therapy.
• Effective menopausal therapy requires symptom relief, noncontraceptive health benefits, and good tolerability.
• Hormone replacement therapy (HRT) offers benefits like vasomotor symptom control, osteoporosis prevention, and potential protection against cardiovascular disease, colon cancer, and Alzheimer's disease.

Purpose of the Study:

• To evaluate the transition from oral contraceptives to hormone replacement therapy.
• To highlight the importance of progestin tolerability in HRT formulations.
• To compare the potential advantages of new HRT formulations.

Main Methods:

• Review of current hormone replacement therapy formulations available in the United States.
• Analysis of available data on the tolerability profiles of different progestins used in HRT.
• Consideration of the transition from oral contraceptive use to HRT.

Main Results:

• Progestin-related side effects are a primary reason for HRT discontinuation.
• Selecting an HRT formulation with a well-tolerated progestin, similar to that in oral contraceptives, can improve adherence.
• Continuous 17beta-estradiol/intermittent norgestimate HRT may offer advantages over older progestin-containing regimens.

Conclusions:

• The choice of progestin in hormone replacement therapy is critical for patient adherence and successful treatment.
• Newer HRT formulations, such as continuous 17beta-estradiol/intermittent norgestimate, show promise for improved tolerability and benefits.
• Further comparative trials are needed to confirm the advantages of novel HRT formulations.