Monitoring of hormone replacement therapy in postmenopausal women by transvaginal sonography and color flow doppler: study in different phases of sequential therapy
C. Exacoustos et al., Monitoring of hormone replacement therapy in postmenopausal women by transvaginal sonography and color flow doppler: study in different phases of sequential therapy, FERT STERIL, 71(3), 1999, pp. 536-543
Objective: To assess uterine artery blood flow and endometrial thickness in
postmenopausal patients receiving sequential hormone replacement therapy (
HRT) at different phases of the treatment.
Design: Prospective controlled study.
Setting: Ultrasound and menopause units of the obstetrics and gynecology de
partment of the University of Tor Vergata, Pome, Italy.
Patient(s): Forty postmenopausal women were treated with cyclic sequential
HRT (transdermal E-2, 50 mu g/d, days 1-21: and dydrogesterone, 10 mg/d, da
ys 12-24).
Intervention(s): All patients underwent transvaginal color Doppler sonograp
hy in the estrogen (phase E) and progestogen (phase E/P) phases and after u
terine bleeding when no hormone was administered (phase 0).
Main Outcome Measure(s): Endometrial thickness: systolic, diastolic, and me
an velocities; and pulsatility and resistance indices of the uterine arteri
es.
Result(s): No statistically significant difference in endometrial thickness
between phase E (6.5 +/- 1.6 mn) and phase E/P (6.0 +/- 1.7 mm) was observ
ed. In phase 0, compared with phases E and E/P, a statistically significant
decrease in endometrial thickness was found (4.1 +/- 1.2 mm). Doppler Row
impedance parameters of uterine arteries during the different phases of thr
HRT cycle showed no differences between the phases considered.
Conclusion(s): The decrease in endometrial thickness in phase 0 suggests a
protective effect of our cyclic sequential regimen on the endometrium. Dydr
ogesterone does not interfere markedly with the vasodilatory effect of estr
ogen on uterine arteries. (Fertil Steril(R) 1999;71:536-43. (C) 1999 by Ame
rican Society for Reproductive Medicine.)