Comparison of continuous versus sequential estrogen and progestin therapy in postmenopausal women

Details

Serval ID
serval:BIB_71BCCBF0BEB7
Type
Article: article from journal or magazin.
Collection
Publications
Title
Comparison of continuous versus sequential estrogen and progestin therapy in postmenopausal women
Journal
Obstetrics and Gynecology
Author(s)
Clisham  P. R., de Ziegler  D., Lozano  K., Judd  H. L.
ISSN
0029-7844
Publication state
Published
Issued date
02/1991
Peer-reviewed
Oui
Volume
77
Number
2
Pages
241-6
Notes
Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S. --- Old month value: Feb
Abstract
A pilot study was performed comparing the efficacy and safety of continuous versus sequential schedules of the two most commonly prescribed medications for ovarian hormone replacement, conjugated equine estrogens and medroxyprogesterone acetate. Bleeding patterns, endometrial histology, and metabolic parameters were studied in 48 postmenopausal women prospectively randomized to a continuous schedule (daily estrogen and progestin) or a sequential schedule (conjugated estrogen on days 1-25, medroxyprogesterone acetate on days 16-25). Doses studied were 0.625 and 1.25 mg of conjugated estrogens and 10 mg of medroxyprogesterone acetate. Significantly greater bleeding was observed with the 1.25-mg dosage of conjugated estrogens. Bleeding patterns were similar between schedules, with the exception that amenorrhea was more prevalent in the women using the 1.25-mg dosage of estrogen and the continuous progestin schedule. More frequent endometrial atrophy was observed with the continuous schedule, supporting the concept that prolonged use of this schedule may promote amenorrhea in most patients. Both doses and schedules were associated with modest and insignificant increases in high-density lipoprotein cholesterol. Sequential therapy did not prevent the estrogen-induced decrease of low-density lipoprotein cholesterol, whereas the continuous schedule did, particularly with 0.625-mg dosage of conjugated estrogens. Significant increases of triglycerides were also seen with the continuous but not with the sequential schedule. Because of reports that the continuous schedule using the 2.5-mg dosage of medroxyprogesterone acetate does not elicit these actions on circulating lipids, attention should be directed toward examining the long-term effects of this lower dosage given continuously.
Keywords
Drug Administration Schedule Endometrium/pathology Estrogen Replacement Therapy/*methods Estrogens, Conjugated (USP)/*administration & dosage Female Humans Lipoproteins/blood Medroxyprogesterone/administration & dosage/*analogs & derivatives Medroxyprogesterone 17-Acetate Menopause/blood/*drug effects Middle Aged Pilot Projects Uterine Hemorrhage/prevention & control
Pubmed
Web of science
Create date
28/02/2008 11:37
Last modification date
20/08/2019 14:30
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