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Vaginal rings delivering progesterone and estradiol may be a new method of hormone replacement therapy
Takeshi Maruo1, Daniel R Mishell, Avraham Ben-Chetrit
1Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Objective:
To determine whether a low dose of P delivered together with E(2) from a vaginal ring on a continuous schedule can prevent endometrial proliferation and yield a bleeding pattern dominated by amenorrhea.
Design:
Longitudinal clinical study.
Setting:
Three university hospitals.
Patient(S):
Fifty-five women 45 to 75 years of age, not hysterectomized, with E(2) levels of <20 pg/mL and hot-flash incidence of two or more per day in the past week.
Intervention(S):
A vaginal ring delivering approximately 150 microg/d of 17beta-E(2) and approximately 5 mg/d or approximately 9 mg/d of P used continuously for 4 and 6 months.
Main Outcome Measure(S):
Endometrial thickness, bleeding pattern, and hot flash incidence.
Result(S):
Endometrial proliferation was prevented by both P doses. Bleeding incidence decreased. In months 4, 5, and 6, 8 of 12 women had no bleeding. Incidence of hot flashes and night sweats decreased quickly and significantly.
Conclusion(S):
A vaginal ring delivering E(2) and a low dose of P merits further study as a method for long-term hormone replacement therapy.