[Sequential administration of norethisterone and natural oral progesterone during premenopausal menstrual cycle...

A sequential treatment either with norethisterone or with oral natural micronized progesterone was administered, after randomization, to 80 women consulting for premenopausal disorders of the menstrual cycle. In all cases, the initial aspect of the endometrium showed a progesterone deficit with hyperplasia in 50 per cent of cases. At the third and sixth month of treatment, none of the biopsies presented hyperplastic characteristics whether after norethisterone or oral progesterone. However, three months after suspension of treatment, the proliferative or hyperplastic characteristics reappeared in 24 per cent of cases in the norethisterone group, and in 10 per cent of cases in the oral progesterone group. The administration of norethisterone induced a decrease in plasma levels of estradiol (E2), FSH and LH, and sex-hormone-binding globulin (SHBG) (p less than 0.001). No modification was observed during treatment with oral progesterone. The plasma levels of HDL-cholesterol and triglycerides were decreased by norethisterone (p less than 0.001-0.02). A slight decrease in phospholipids was also observed in this group. Treatment with oral natural micronized progesterone therefore offers an attractive alternative for the treatment of premenopausal menstrual disorders.