Comparison of bleeding patterns with continuous combined hormone therapy regimen in postmenopausal women

Abstract

Objective: To determine the effects of four different types of oral combined continuous hormone replacement therapies on vaginal bleding in postmenopausal women. Materials and Methods: This was a 1 year, prospective, randomized study including 37O postmenopausal women ages between 4057. Tibolone, estradiol hemihidrate 2mg/day + noretisteron acetate 1 mg/day, conjugated estrogen 0.625 mg/day+medroxyprogesteron acetate 2.5 mg/day, conjugated estrogen 0.625 mg/day +medroxyprogesteron acetate 5 mg/day therapies were used by the four study groups. Postmenopansal women were called back for three monthperiods. Results: There was no significant difference for bleeding patterns between the study groups during treatment period. At the end of 1 year, Tibolone and estradiol hemihidrate 2 mg/day + noretisteron acetate Img/day usage did not increase bleeding risk. However relative risk as 3.5-2.2 was found with conjugated estrogen 0.625mg /day+medroxyprogesteron acetate 2.5 mg/day and conjugated estrogen 0.625 mg/day +medroxyprogesteron acetate 5mg/day therapies. Conclusion: At the end of one year followup %96100 of the postmenopausal women had amenorrhea. Irregular bleeding was seen often at the first three months of therapy, and the incidence tended to increase during study. Contrary to literature, the incidence of vaginal bleeding was less in the estradiol hemihidrate 2 mg/day + noretisteron acetate Img/day group when compared with the tibolone group.

Keywords

• Vaginal bleeding,Prospective Studies,Hormone Replacement Therapy,Drug Combinations,Hemorrhage,Postmenopause

Kesintisiz kombine hormon replasman tedavisi kullanan postmenopozal kadınlarda vaginal kanama paternlerinin karşılaştırılması

Öz

Amaç: Postmenopozal kadınlarda 4 farklı kombine sürekli hormon replasman tedavi rejiminin vaginal kanama üzerine olan etkilerinin değer lendirilmesi Materyal ve Metod: Çalışma 4057 yaşlan arasında olan 370 postmenopozal kadını içeren 1 yıllık randomize, prospektif olarak planlandı. Tibolon, östradiol hemihidrat 2 mg/gün + noretisteron asetat 1 mg/gün, konjuge östrojen 0.625 mg/gün+medroksiprogesteron asetat 2.5 mg/gün, konjuge östrojen 0.625 mg/gün+ medroksiprogesteron asetat 5 mg/gün tedavileri uygulandı, 4 farklı grup oluşturuldu.Hastalara l yıl içinde 3 aylık periodlarla kontrole çağırıldı. Bulgular: Gruplar arasında tedavi süresince vaginal kanama görülme sıklığı açısından anlamlı fark tespit edilmedi, 1.yıl sonunda tibolon ve östradiol hemihidrat 2mg/gün+noretisteron asetat 1 mg/gün kullanımının kanama riskini artırmadığı, buna karşılık konjuge östrojen 0.625 mg/gün +medroksiprogesteron asetat 2.5 veya 5 mg/gün tedavisinde rölatif risk 3.5 - 2.2 bulundu. Sonuç: l yıllık takip süresinin sonunda çalışmaya katılan kadınların % 96100'ünün amenoreik olduğu görüldü.Düzensiz kanama sıklıkla tedavinin ilk 3 ayında izlendi ve ilerleyen tedavi aylarında bu eğilimin azaldığı saptandı. Literatürde belirtilenin aksine vaginal kanama sıklığının, östradiol hemihidrat 2mg/gün+noretisteron asetat 1mg/gün kullanılan grupta tibolone grubunda saptanandan daha az olduğu tespit edildi.

Anahtar Kelimeler

• Vajinal kanama,İleriye dönük çalışma,Hormon replasman tedavisi,İlaç kombinasyonları,Kanama,Postmenopoz

Kaynakça

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