Constant estrogen, intermittent progestogen vs. continuous combined hormone replacement therapy: tolerability and effect on vasomotor symptoms

Objective: To compare the efficacy and tolerability of a novel oral constan t estrogen plus intermittent progestogen hormone replacement therapy (HRT) regimen to a continuous combined HRT regimen in postmenopausal women. Metho ds: Subjects were randomly assigned to receive treatment with either consta nt 17 beta -estradiol (E-2), 1 mg, plus intermittent norgestimate (NGM) 90 mug (3 days off, 3 days on) (n = 221) or E-2 2 mg/norethisterone acetate (N ETA) 1 mg (II = 217) for i year. Treatments were evaluated based on the inc idence of hot flushes and uterine bleeding. Results: Both regimens had simi lar bleeding profiles and provided comparable vasomotor symptom relief. How ever, breast discomfort and edema were experienced by twice as many subject s who received E-2/NETA. Conclusions: The constant E-2/intermittent NGM reg imen was well tolerated and possesses similar efficacy compared with a cont inuous combined E-2/NETA regimen and may be considered whenever HRT without withdrawal bleeding is deemed appropriate. (C) 2001 International Federati on of Gynecology and Obstetrics. All rights reserved.