medrogestone and Amenorrhea

In this study menopausal symptoms, endometrial histology, uterine bleeding pattern, plasma lipid concentrations, bone mineral loss, body weight and blood pressure have been evaluated in postmenopausal women who received continuous conjugated equine estrogens and medrogestone over a 1 year treatment period. By the third month of therapy we detected a significant (p < 0.01) improvement in postmenopausal symptomatology. At the 6th and 12th month, endometrial biopsy specimens revealed atrophic endometrium in all women. Uterine bleeding episodes were observed especially during the first months of treatment. Amenorrhoea was found in all patients only after 8 months of therapy. By the 6th month of therapy, we observed a significant (p < 0.01) decrease of plasma cholesterol and low-density lipoprotein cholesterol levels. Instead, plasma high-density lipoprotein and triglycerides concentrations didn't show significant variation from baseline values. No significant changes in bone mineral density could be detected after 12 months of treatment. Body weight and blood pressure were not significantly altered from baseline. This study suggests that continuous conjugated equine estrogens plus medrogestone treatment appears to be an interesting and safe manner to administer postmenopausal hormone replacement therapy. This regimen could represent a good alternative to sequential estroprogestin therapy in women who do not tolerate withdrawal bleeding.

Topics: Amenorrhea; Atrophy; Biopsy; Dose-Response Relationship, Drug; Endometrial Hyperplasia; Endometrium; Estrogen Replacement Therapy; Estrogens, Conjugated (USP); Female; Humans; Lipoproteins; Medrogestone; Middle Aged; Osteoporosis, Postmenopausal; Triglycerides; Uterine Hemorrhage

Dual energy X-ray absorptiometry of bone density in the lumbar vertebral column was performed in 32 young women (mean age 24.6 [19-34] years) with hypergonadotropic hypogonadal amenorrhoea. There was a significantly lower bone density (0.74 +/- 0.27 g/cm2) than in a control group of 27 women of similar age (1.17 +/- 0.081 g/cm2; P less than 0.001). Subsequently 21 of the 32 women received cyclical hormone substitution therapy for 24 months (day 1-30: 0.625 mg conjugated oestrogens; additionally, on days 20-30: 5 mg medrogestone; followed by a seven-day pause). After 6 months bone density, compared with that of the 11 untreated women, had increased significantly (P less than 0.001). It is therefore recommended that young hypoestrogenemic women should receive early and continuous hormone substitution treatment.

Topics: Absorptiometry, Photon; Adult; Amenorrhea; Bone Density; Drug Therapy, Combination; Estradiol; Estradiol Congeners; Female; Follicle Stimulating Hormone; Humans; Hypogonadism; Luteinizing Hormone; Medrogestone; Time Factors