[Propause survey: profile of patients treated with progestins in perimenopause]

Progestins are widely used in France for treatment of perimenopause.

To evaluate the real use of progestins in daily practice.

A transverse epidemiological survey conducted between May and June 1998, by 284 gynecologists representative of French private practitioner gynecologists, who selected the first 4 patients treated with progestins for perimenopause.

For 887 observations collected, the most frequent indications of prescription were: functional disorders of perimenopause (57%), mastalgia (47%), premenstruel syndrome (38%), endometrial pathology (29%) and ovulation inhibition (28%). Multiple reasons were present in 81% of patients: when progestin was prescribed more than 10 days per cycle, breast pathologies were the most frequent indication and the length of treatment was more than one year; when progestin was prescribed 10 days per cycle, isolated menstrual irregularities (without breast or endometrium pathology) predominated and the length of treatment was one year or less. The most widely used progestin classes were pregnanes and norpregnanes; there was an estrogene co-prescription in 17% of cases, more frequently in women with perimenopause disorders.

We found the following pattern for progestin prescription in perimenopause: 10-day prescription for one-third of the women, 11 to 15 days for one-third, and 20 days per cycle for one-third. We thus observe some differences with recommended use. This difference is observed either with the initial prescription or with symptom-related dose adaptation.