Nylestriol replacement therapy in postmenopausal women. A three-year prospective study

Area of Science:

• Endocrinology
• Reproductive Medicine
• Gerontology

Background:

• Menopause is associated with hormonal changes and increased health risks.
• Estrogen replacement therapy (ERT) is used to manage menopausal symptoms and prevent associated conditions.
• Long-acting estrogen derivatives offer potential for improved adherence and efficacy.

Purpose of the Study:

• To evaluate the efficacy and safety of nylestriol, a long-acting estriol derivative, as ERT in postmenopausal women.
• To assess the effects of nylestriol on lipid profiles, bone metabolism, menopausal symptoms, and endometrial and breast health.

Main Methods:

• A three-year prospective study involving 283 postmenopausal women.
• Randomized assignment into three groups: nylestriol 2 mg/2 weeks, nylestriol 1 mg/2 weeks, and placebo.
• Evaluation of lipid profiles, biochemical markers, bone mineral content, Kupperman index, and endometrial/breast status.

Main Results:

• Nylestriol significantly decreased LDL-C and increased HDL-C after 3 months.
• Serum ALP, Ca/Cr, and Hpr/Cr in fasting urine decreased, and forearm bone mineral content loss was restrained.
• Kupperman index scores reduced by approximately 50% at 3 months and 80% at 12 months.
• Mild endometrial stimulation observed; no obvious effect on the breast.

Conclusions:

• Nylestriol is an effective and acceptable ERT for postmenopausal women.
• It improves lipid profiles, preserves bone density, and alleviates menopausal symptoms.
• Concurrent provera is recommended to manage endometrial stimulation.