Evaluation of a continuous combined low-dose regimen of estrogen-progestin for treatment of the menopausal patient

Article Abstract:

During menopause women stop producing estrogen, a hormone known to protect the body against bone loss (osteoporosis) and coronary artery disease, a major cause of death in menopausal women. Estrogen therapy is offered to menopausal women to replace lost estrogen and to prevent symptoms experienced during menopause. The addition of progesterone for 10 to 14 days each month helps prevent the endometrial cancer that can develop when estrogen is given alone. Traditionally, estrogen and progesterone have been given sequentially, that is, estrogen and progesterone are taken on assigned days every month. Continuous estrogen replacement therapy with progesterone may offer more beneficial cardiovascular effects and cause fewer symptoms than sequential treatments. To see if the overall effects of hormone replacement therapy are altered by continuous estrogen and progesterone therapy, a total of 92 patients were studied. One group of 46 menopausal women were given 0.625 milligrams (mg) of estrogen and 2.5 mg of progesterone continuously (every day of the month). The other group of 46 women received the same dose of estrogen, but with 5 mg of progesterone. The therapy was continued for a total of 52 weeks. Both regimens maintained a protective lipid profile (related to cardiovascular risk status), reduced menopausal symptoms, and an unchanged endometrium. A decrease in vaginal bleeding was also noted, particularly after 26 weeks of therapy. There were no significant differences between the two doses of progesterone. It is suggested that patients begin with the lower dose of progesterone and if bleeding or endometrial cell changes are detected, the dose can be increased to 5 mg. Continuous hormone therapy is easier to follow, and it is thought that more women would be compliant with this program, especially if vaginal bleeding is reduced. In this way, women can continue experiencing the protective benefits of estrogen, including reduced risk for coronary artery heart disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Dosage and administration, Progesterone

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Estrogen and interrupted progestin: a new concept for menopausal hormone replacement therapy

Article Abstract:

Treatment with continuous estrogen and interrupted progestin may be a new type of hormone replacement therapy for postmenopausal women. Postmenopausal women may require hormone therapy to control hot flashes, to increase or maintain bone mass and to prevent cardiovascular disease or endometrial cancer. Thirty-seven postmenopausal women between 40 and 60 years old were treated with 0.75 milligrams (mg) of piperazine estrone sulfate per day and 0.35 mg of norethindrone per day in three-day phases. This treatment alternated with three-day phases of no progestin treatment over a two-year period. Seventy-six percent of the women experienced complete elimination of hot flushes, and 80% did not experience any bleeding after six months of treatment. Endometrial biopsies after six, 12 and 24 months of treatment did not reveal endometrial hyperplasia in any of the women. Endometrial hyperplasia is an increase in the number of cells in the lining of the uterus.

Progestational hormones

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Effects of low-dose continuous combined conjugated estrogens and medroxyprogesterone acetate on menopausal symptoms, body weight, bone density, and metabolism in postmenopausal women

Article Abstract:

Combined hormone therapy that includes estrogen, medroxyprogesterone acetate, and calcium may be effective in treating menopausal symptoms and preventing osteoporosis. The therapy contained low doses of estrogen to minimize the adverse effects of estrogen.

Prevention, Osteoporosis

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