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Related Experiment Videos

Bleeding pattern and endometrial changes during continuous combined hormone replacement therapy. The Ogen/Provera

S L Nand1, M A Webster, R Baber

  • 1School of Obstetrics and Gynaecology and the Sydney Menopause Centre, Royal Hospital for Women, Randwick, NSW, Australia.

Obstetrics and Gynecology
|May 8, 1998
PubMed
Summary

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This study found that all tested doses of medroxyprogesterone acetate combined with estrone sulfate effectively protect the endometrium and achieve amenorrhea in most postmenopausal women within six months of hormone replacement therapy.

Area of Science:

  • Reproductive Endocrinology
  • Gynecology
  • Pharmacology

Background:

  • Hormone replacement therapy (HRT) is used for menopausal symptom management.
  • Endometrial protection is crucial during HRT to prevent hyperplasia.
  • Estrone sulfate (E1S) and medroxyprogesterone acetate (MPA) are common HRT components.

Purpose of the Study:

  • To determine the optimal oral daily dose of micronized MPA for endometrial protection.
  • To identify the MPA dose that induces amenorrhea when combined with a fixed E1S dose.
  • To evaluate MPA's efficacy in HRT for postmenopausal women.

Main Methods:

  • A 2-year, multicenter, randomized, double-blind study.
  • 568 postmenopausal women received E1S (1.25 mg daily) plus MPA (2.5, 5, or 10 mg daily).

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  • Vaginal bleeding was self-recorded; endometrial biopsies were performed at baseline and at 3, 12, and 24 months.

    • Main Results:

    • Amenorrhea rates by 6 months were 76.5% (2.5 mg MPA), 80.1% (5 mg MPA), and 80.9% (10 mg MPA).
    • By 24 months, amenorrhea rates reached 91.5% (2.5 mg) and 94.3% (10 mg MPA).
    • No statistically significant differences in bleeding were observed between groups; no endometrial hyperplasia occurred.

    Conclusions:

    • All tested MPA doses (2.5, 5, 10 mg) with E1S (1.25 mg) provide adequate endometrial protection.
    • Approximately 80% of women achieved amenorrhea by 6 months of HRT.
    • The combination therapy is effective for endometrial safety and bleeding cessation in postmenopausal women.