Compliance considerations with estrogen replacement: withdrawal bleeding and other factors
Article Abstract:
During menopause estrogen is no longer produced by the ovaries. Estrogen replacement therapy can prevent the development of hot flashes, vaginal and bladder symptoms, osteoporosis (bone loss) and coronary heart disease. Although the benefits of estrogen replacement therapy are great, side effects can cause women to stop taking the drug. Withdrawal bleeding is the most bothersome side effect and most patients who discontinue therapy complain of annoying breakthrough bleeding. Cyclic combination estrogen replacement therapy includes the use of estrogen given for 21 days with progesterone introduced on days 12 through 21. Vaginal bleeding could begin between day 12 and day 21. Other undesirable effects include symptoms similar to those found in premenopausal ovulating women, such as swelling, bloating, premenstrual irritability, cramping, painful periods and breast tenderness. Adjusting estrogen and progesterone doses can help manage some of these symptoms. Patients can also take estrogen and progesterone continuously. The start of menstruation-type vaginal bleeding and the possibility of breast or endometrial cancer discourage patients from trying estrogen replacement therapy regimes. It is suggested that the benefits of estrogen replacement therapy, which include protection from coronary heart disease and osteoporosis, should be emphasized to improve patient compliance. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1989
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Effects of estrogen replacement therapy on plasma levels of nitric oxide in postmenopausal women
Article Abstract:
Estrogen replacement therapy may protect postmenopausal women from heart disease by increasing blood levels of nitric oxide. Nitric oxide relaxes blood vessels. Researchers measured blood levels of nitric oxide in 28 postmenopausal women who were randomly assigned to receive estrogen or a placebo via a skin patch for six months. Nitric oxide levels were similar in both groups at the beginning of the study, but increased in the women receiving estrogen over the next six months. When they stopped taking estrogen, their nitric oxide levels fell back to the levels seen at the beginning of the study.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1999
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