UTERINE PERFUSION AND ENDOMETRIAL THICKNESS IN POSTMENOPAUSAL WOMEN ON LONG-TERM CONTINUOUS COMBINED ESTROGEN AND PROGESTOGEN REPLACEMENT

We assessed the resistance index (RI) and pulsatility index (PI), peak and average systolic velocities in uterine, arcuate and radial arteri es, and endometrial thickness (ET) by transvaginal B mode and color Do ppler sonography in patients on continuous combined hormonal replaceme nt therapy (HRT) and controls. HRT consisted of 2 mg estradiol, 1 mg e striol and I mg norethisterone acetate daily (n = 33) compared to cont rols, who received none of these (n = 21). Age was 61 +/- 6 and 59 +/- 9 years (mean +/- standard deviation) in the HRT and control groups, respectively. The duration of HRT was 5 +/- 2 years, with a minimum of 2 year. We found that the uterine RI and, to a lesser extent, the ute rine PI were significantly lower and the radial peak systolic velociti es were significantly higher in the HRT group compared to controls. Th e highest uterine PI values were measured in controls with the shortes t life-time exposure to endogenous estrogens, i.e. late menarcheal age or early menopause. The endometrial thickness of 2.8 +/- 1.8 mm in th e HRT group was not significantly different from that in the controls (4.2 +/- 5.6 mm). In conclusion, the alteration in blood flow paramete rs demonstrated in this study would suggest that the long-term use of continuous oval estradiol 2 mg, estriol 1 mg and norethisterone acetat e 1 mg daily is associated with a slight increase of flow in the uteri ne arteries compared to controls matched for (postmenopausal) age. End ometrial thickness does not increase with duration of use of continuou s combined HRT.