Bleeding patterns in postmenopausal women using continuous combination hormone replacement therapy with conjugated estrogen and medroxyprogesterone acetate or with 17beta-estradiol and norethindrone acetate.

Abstract

OBJECTIVE:

We studied bleeding patterns in postmenopausal women who were using 2 types of continuous combination regimens.

STUDY DESIGN:

A prospective, double-blind, randomized study of 208 postmenopausal women treated with conjugated estrogen, 0.625 mg, and medroxyprogesterone acetate, 5 mg, or with 17beta-estradiol, 2 mg, and norethindrone acetate, 1 mg.

RESULTS:

The mean number of bleeding days decreased during the first 4 months of treatment (P <.002) but not thereafter. The number of bleeding days was fewer (P <.002) and the time until amenorrhea was shorter (P <.02) in patients receiving conjugated estrogen and medroxyprogesterone acetate than in patients receiving 17beta-estradiol and norethindrone acetate. The odds ratio for progression to amenorrhea with the use of conjugated estrogen and medroxyprogesterone acetate was 1.58, in comparison with the use of 17beta-estradiol and norethindrone acetate. A thick endometrium at the start of treatment resulted in more bleeding days than were found for a thin endometrium (P <.03). Body mass index, age, and blood pressure had no predictive value for bleeding problems.

CONCLUSIONS:

Treatment with continuous combined conjugated estrogen and medroxyprogesterone acetate resulted in fewer bleeding problems than did treatment with 17beta-estradiol and norethindrone acetate. Endometrial thickness may help to predict the chance of achieving amenorrhea during early hormone replacement therapy.

• Authors: I S Odmark, B Jonsson, T Bäckström
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 184 Issue 6 Pg. 1131-8 (May 2001) ISSN: 0002-9378 [Print] United States
• PMID: 11349178 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Drug Combinations
• Estrogens, Conjugated (USP)
• Estradiol
• Norethindrone Acetate
• Medroxyprogesterone Acetate
• Norethindrone

Topics

• Aging (physiology)
• Blood Pressure
• Double-Blind Method
• Drug Combinations
• Endometrium (drug effects, pathology)
• Estradiol (adverse effects)
• Estrogens, Conjugated (USP) (adverse effects)
• Female
• Hormone Replacement Therapy (adverse effects)
• Humans
• Medroxyprogesterone Acetate (adverse effects)
• Menstruation
• Middle Aged
• Norethindrone (adverse effects, analogs & derivatives)
• Norethindrone Acetate
• Postmenopause (physiology)
• Prospective Studies