The influence of smoking on uterine bleeding during sequential oral hormone therapy.

Abstract

OBJECTIVE:

To study the influence of smoking on uterine bleeding patterns during sequentially administered oral hormone therapy (HT).

METHODS:

Using a post-hoc strategy, we included four sequential oral HT groups from two studies. The therapies consisted of estradiol from days 1 to 28 (estradiol or estradiol valerate) and progestogen (levonorgestrel or gestodene) on days 17-28. A total of 111 healthy, early postmenopausal women (38 smokers and 73 non-smokers) followed for 2 years were included in the analyses. Uterine bleeding data were collected from bleeding calendars.

RESULTS:

On the regimen containing levonorgestrel, smoking women had a cyclical bleeding significantly earlier than non-smoking women (about 2 days' difference). Moreover, smoking women had significantly longer bleeding than non-smoking women (about 1 day in difference). This was in contrast to the three regimens containing gestodene, where smoking seemed to have far less influence on uterine bleeding.

CONCLUSIONS:

On a regimen containing levonorgestrel, smokers exhibit an earlier and longer uterine bleeding than do non-smokers. This is in contrast to regimens containing gestodene, where smoking women are less likely to differ from non-smoking women with regard to bleeding. This indicates that smoking influences progestogen metabolism, and that this influence may vary with different progestogens. Further studies are needed.

• Authors: N H Bjarnason, I Byrjalsen, H L Jørgensen, C Christiansen
• Journal: Climacteric : the journal of the International Menopause Society (Climacteric) Vol. 10 Issue 2 Pg. 147-54 (Apr 2007) ISSN: 1369-7137 [Print] England
• PMID: 17453863 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Contraceptive Agents
• Norpregnenes
• Gestodene
• Estradiol
• Levonorgestrel

Topics

• Administration, Oral
• Contraceptive Agents (administration & dosage)
• Estradiol (administration & dosage, analogs & derivatives)
• Estrogen Replacement Therapy
• Female
• Humans
• Levonorgestrel (administration & dosage, blood)
• Middle Aged
• Norpregnenes (administration & dosage, blood)
• Postmenopause (physiology)
• Randomized Controlled Trials as Topic
• Smoking (physiopathology)
• Uterine Hemorrhage (physiopathology)