Leather A T, Savvas M, Studd J W
Kings College Hospital, London, United Kingdom.
Obstet Gynecol. 1991 Dec;78(6):1008-10.
Continuous combined estrogen and progestogen preparations enable the postmenopausal woman to enjoy the benefits of estrogen replacement without the inconvenience of regular progestogen-induced withdrawal bleeding. The endometrium appears to be adequately protected in the short term, but no published data are available on the bleeding patterns or endometrial response after more than 18 months of therapy. Therefore, we reviewed 41 patients who continued on such preparations for up to 10 years (mean duration of use 8.0 years). Six women had experienced episodes of breakthrough bleeding after achieving amenorrhea, two of whom had benign endometrial polyps and two with adenocarcinoma of the endometrium. The remaining 35 women each had prolonged amenorrhea and were found to have an atrophic inactive endometrium. It is too early to comment on the long-term endometrial effects of these preparations because the numbers are too small; however, any breakthrough bleeding occurring after a period of prolonged amenorrhea must be investigated by means of endometrial biopsy.
连续联合雌激素和孕激素制剂使绝经后女性能够享受雌激素替代的益处，而无需承受常规孕激素引起的撤退性出血带来的不便。短期内子宫内膜似乎得到了充分保护，但尚无超过18个月治疗后的出血模式或子宫内膜反应的公开数据。因此，我们回顾了41例持续使用此类制剂长达10年（平均使用时间8.0年）的患者。6名女性在闭经后出现了突破性出血，其中2人患有良性子宫内膜息肉，2人患有子宫内膜腺癌。其余35名女性均有长期闭经，且子宫内膜萎缩无活性。由于数量过少，现在对这些制剂的长期子宫内膜影响进行评论还为时过早；然而，在长期闭经后出现的任何突破性出血都必须通过子宫内膜活检进行调查。
