A COMPARATIVE-STUDY OF THE EFFECTS OF AN ESTRADIOL-RELEASING VAGINAL RING COMBINED WITH AN ORAL GESTAGEN VERSUS TRANSDERMAL ESTROGEN COMBINED WITH A LEVONORGESTREL-RELEASING IUD - CLINICAL FINDINGS AND ENDOMETRIAL RESPONSE

Objective-Our purpose was to compare the effects of a new estradiol-re leasing vaginal ring with an oral progestin versus the efficacy, safet y and acceptability of an intrauterine device releasing levonorgestrel combined with estradiol, delivered transdermally from a patch. Climac teric symptoms, bleeding pattern, and endometrial histologic features were studied. Materials and Methods-Fifty-six parous, postmenopausal w omen with urogenital symptoms were allocated to two groups for 1 year' ' 28 women receiving estradiol by a vaginal ring (2 mg/3 months) and a n oral progestin for 7 days every month and 28 women receiving a conti nuous transdermal daily dose of 50 mu g of estradiol with a levonorges trel-releasing (20 mu g/day) intrauterine device inserted. All the pat ients were subjected to vaginosonographic examination followed by thor ough pathological examination of uterine curetting samples. Results-A mean endometrial thickness (double layer) of 2.9 and 3.0 mm, respectiv ely, was found to be predictive of normal endometrium. Both treatment regimens effectively relieved urogenital symptoms. Endometrial prolife ration was not observed. Conclusions-Treatment of urogenital symptoms in postmenopausal women with these two forms of hormone replacement th erapy was shown to be an effective and safe method, exhibiting possibl e advantages over other methods of treatment.