TRANSDERMAL ESTROGEN WITH A LEVONORGESTREL-RELEASING INTRAUTERINE-DEVICE FOR CLIMACTERIC COMPLAINTS VERSUS ESTRADIOL-RELEASING VAGINAL RINGWITH A VAGINAL PROGESTERONE SUPPOSITORY - CLINICAL AND ENDOMETRIAL RESPONSES

Objective: Our purpose was to compare the effects of a new estradiol-r eleasing vaginal ring with progesterone given as a vaginal suppository , versus the efficacy, safety and acceptability of an intrauterine dev ice releasing levonorgestrel combined with estradiol, delivered transd ermally from a patch. Climacteric symptoms, bleeding pattern and endom etrial histologic features were studied. Methods: Fifty six parous, po stmenopausal women with urogenital symptoms were allocated in two grou ps for one year: 28 women receiving estradiol by a vaginal ring and a 100 mg vaginal progesterone suppository 7 days every month and 28 wome n receiving a continuous transdermal daily dose of 50 mu g of estradio l with a levonorgestrel-releasing intrauterine device inserted. All th e patients were subjected to vaginosonographic examination followed by thorough pathological examination of the uterine curetting samples. R esults: A mean endometrial thickness (double layer) of 2.9 and 3.0 mm, respectively, was found to be predictive of normal endometrium. Both treatment regimens effectively relieved climacteric symptoms. Endometr ial proliferation was not observed. Spotting was more common in the in trauterine device group than in the vaginal ring group. Conclusions: T reatment of urogenital symptoms in postmenopausal women with these two forms of hormone replacement therapy is shown to be an effective and safe method, exhibiting advantages over other methods of treatment. (C ) 1997 Elsevier Science Ireland Ltd.