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Postmenopausal hormone replacement with a combination estrogen-progestin regimen for five days per week
D R Mishell1, D Shoupe, D L Moyer
1Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles 90033.
The Journal of Reproductive Medicine
|May 1, 1991
Summary
This study found that a weekday-only regimen of conjugated equine estrogen and medroxyprogesterone acetate in postmenopausal women led to minimal endometrial changes and reduced bleeding. Further trials comparing this to daily dosing are recommended for hormone therapy.
Area of Science:
- Reproductive Endocrinology
- Pharmacology
Background:
- Hormone replacement therapy (HRT) is used for menopausal symptoms.
- Estrogen-progestogen therapy requires careful endometrial monitoring.
- Alternative HRT dosing schedules may impact efficacy and side effects.
Purpose of the Study:
- To evaluate the endometrial effects and bleeding patterns of a 5-day-per-week conjugated equine estrogen and medroxyprogesterone acetate regimen.
- To assess the impact of this intermittent HRT regimen on lipid profiles.
Main Methods:
- 15 postmenopausal women received 0.625 mg conjugated equine estrogen and 2.5 mg medroxyprogesterone acetate Monday-Friday for 6 months.
- Endometrial biopsies were performed post-therapy.
- Lipid profiles (HDL, LDL) were monitored.
Main Results:
- Endometrial biopsies showed minimal glandular and stromal growth with low mitosis.
- 5 of 12 completers were amenorrheic; only 4/15 bled beyond 2 months.
- Significant increase in HDL and non-significant decrease in LDL cholesterol observed.
Conclusions:
- A 5-day-per-week estrogen-progestogen regimen demonstrates limited endometrial proliferation and reduced bleeding.
- This dosing schedule may offer a favorable lipid profile.
- Comparative studies with daily dosing are warranted.