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Cyclic hormone replacement therapy using quarterly progestin

B Ettinger1, J Selby, J T Citron

  • 1Division of Research, Kaiser Permanente Medical Care Program, Oakland, California.

Obstetrics and Gynecology
|May 1, 1994
PubMed
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Quarterly progestin in hormone replacement therapy is as safe as monthly use for preventing endometrial hyperplasia. Most women preferred the less frequent regimen despite increased bleeding, indicating a potential benefit for symptom relief.

Area of Science:

  • Reproductive endocrinology
  • Gynecologic oncology

Background:

  • Postmenopausal hormone replacement therapy (HRT) often includes cyclic progestin to prevent endometrial hyperplasia.
  • Monthly progestin administration can lead to frequent menstrual bleeding, impacting patient compliance and quality of life.

Purpose of the Study:

  • To evaluate the safety and efficacy of quarterly cyclic progestin versus monthly cyclic progestin in postmenopausal HRT.
  • To assess endometrial hyperplasia risk and menstrual patterns with a quarterly progestin regimen.

Main Methods:

  • A 1-year trial involving 214 postmenopausal women on HRT.
  • Intervention: Switching from monthly to quarterly medroxyprogesterone (10 mg/day for 14 days).
  • Endometrial biopsies and bleeding diaries were used for assessments.

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Main Results:

  • Endometrial hyperplasia rates were similar between quarterly (1.5%) and monthly (0.9%) progestin use.
  • Quarterly use led to longer menses, heavier bleeding, and more unscheduled bleeding.
  • Despite bleeding changes, women preferred the quarterly regimen nearly 4:1.

Conclusions:

  • Quarterly medroxyprogesterone in HRT is as safe as monthly administration regarding endometrial hyperplasia risk.
  • The quarterly regimen is preferred by most women, offering a potential alternative for those seeking reduced dosing frequency.