THE EFFECT OF TRANSDERMAL ESTRADIOL ON BLEEDING PATTERN, HORMONAL PROFILES AND SEX STEROID-RECEPTOR DISTRIBUTION IN THE ENDOMETRIUM OF NORPLANT USERS

The most common side-effect and reason for discontinuation with Norpla nt use is bleeding disturbance, The aim of this study was to investiga te whether the 6 week application of a patch which released 100 mu g/d ay oestradiol would reduce the number of abnormal bleeding days or eli minate the problem, Another objective was to find out the correlation between the bleeding pattern and endometrial concentrations of oestrog en receptor (ER) and progesterone receptor (PR), Of 98 Norplant users, 34 patients had normal bleeding patterns and 64 patients had abnormal bleeding patterns, An oestradiol patch or a placebo patch were random ly used to treat 33 and 31 women with abnormal bleeding respectively, There was a clinical improvement in the oestradiol group compared with the placebo group, although this was not statistically significant, T here were no correlations between PR and ER concentration and the seru m oestradiol, progesterone, levonorgestrel and sex hormone-binding glo bulin concentrations, Significantly increased mean immunostaining scor es of stromal PR were observed in those Norplant users whose endometri um had an atrophic histological appearance. The serum oestradiol conce ntration did not show a significant change after treatment with the oe stradiol patch compared with the placebo patch.