Comparison of two HRT regimens with bimonthly and monthly progestin administration in postmenopause

Objectives: Here we report the results of a study in which natural estrogen s were given transdermally cyclically and continuously for 1 year and a pro gestin of the latest generation, namely nomegestrol acetate, was given for 10 days every month and for 15 days every 2 months. Methods: The patients w ere a group of 34 post-menopausal women (51-56 years), 18 of whom (group A) were treated with continuous transdermal estradiol (50 mu g/day) and cycli c oral nomegestrol at a dose of 5 mg/day for 15 days every 2 months for 1 y ear. The other 16 women (group B) were treated with cyclic transdermal estr adiol for 3 weeks with oral nomegestrol for 10 days (12-21)/month. Endometr ial thickness was evaluated by transvaginal ultrasonography before and afte r treatment. At the end of treatment, an endometrial biopsy was performed. Serum total cholesterol, HDL, LDL and triglycerides were assessed at baseli ne and every 4 months. The characteristics of the cycle were deduced from t he diary cards recorded by the women. Results: No significant differences w ere found in the mean interval between the last dose of nomegestrol and the start of bleeding or in the duration of bleeding. The total number of days of bleeding per year was significantly lower in group A than group B (27 /- 12 vs 52 +/- 18; P < 0.01). Total serum cholesterol and LDL significantl y decreased after I year of treatment in both groups, HDL-cholesterol and t riglycerides were found increased at most of the time points studied. Concl usions: The present protocol involving continuous transdermal administratio n of estrogen combined with oral progestin every 2 months gave good control of the menstrual cycle, did not increase the risk of endometrial pathology and met with good patient compliance. (C) 1999 Elsevier Science Ireland Lt d. All rights reserved.