CYCLIC-COMBINED CONJUGATED ESTROGENS AND DYDROGESTERONE IN THE TREATMENT OF POSTMENOPAUSAL SYNDROME

We report the data concerning postmenopausal women treated either with a calcium supplement (500 mg/day, group 1, n = 13) or with cyclic con jugated estrogens (0.625 mg/day) and dydrogesterone (5 mg/day) far 21 days with a 7-day free interval (n = 27, group 2) for 24 months. Withd rawal bleeding was regular, starting 1-2 days after the fast treatment day and defined as light or mild. No sign of endometrial hyperstimula tion was found by hysteroscopy and endometrial biopsy performed after 24 months of treatment. In group 1, constant levels of both urinary ex cretion of hydroxyproline and plasma osteocalcin were observed, along with a significant (p < 0.05) decrease in vertebral bone mineral densi ty. In group 2, both urinary excretion of hydroxyproline and plasma os teocalcin levels were significantly (p < 0.05) decreased and vertebral bone density showed a slight but significant (p < 0.05) increase. In group 1, a significant (p < 0.05) increase in serum tow-density lipopr otein (LDL)-cholesterol levels was observed, whereas no modification i n total cholesterol, high-density lipoprotein (HDL)-cholesterol and tr iglycerides was found. In group 2, total cholesterol and LDL-cholester ol levels significantly (p < 0.05) decreased, whereas triglycerides le vels were stable throughout the study. In this group, HDL-cholesterol levels showed a significant (p < 0.05) increase. In conclusion, the re gimen for cyclic combined estrogen-progestogen therapy attenuates blee ding disturbances and results in a low dropout rate. Thus, the clinica l and metabolic actions, as well as the protective effects on the endo metrium, make this treatment of potential interest. Further studies ar e required to confirm the long-term beneficial effects of this formula on cardiovascular protection and fracture rate.