Carranza-Lira Sebastián, Gooch Ana Luz MacGregor, Saldivar Nadia, Osterwalder Max Saráchaga
Gynecologic Endocrinology Department Hospital de Ginecología y Obstetricia Luis Castelazo Ayala, DF México.
Int J Fertil Womens Med. 2007 Mar-Jun;52(2-3):93-6.
Hormone therapy (HT) is one the best options for climacteric symptom control; however when women are switched to raloxifene, after several years of HT, they restart with symptoms.
To evaluate the effect of the addition of low-dose esterified conjugated estrogens to the conventional dose of raloxifene in the control of climacteric symptoms.
14 healthy postmenopausal patients were studied. Climacteric symptoms were evaluated at baseline and 3 months after the beginning of treatment by the Kupperman's index (KI) and by the sum of the symptom evaluations carried out with an analog visual scale called SUMEVA. In all the anthropometric variables were documented, as well as time since menopause and endometrial thickness. At random they were distributed in some of the following groups: I) Raloxifene 60 mg/day (n=7) and II) Raloxifene 60 mg/day plus esterified conjugated estrogens 0.312 mg/day (n=7).
Differences among the groups, as well as those among baseline and those at the end of treatment, were determined by student's t test for independent samples and paired samples respectively.
There were no differences in anthropometric variables, nor in the time since menopause. After three months of treatment the libido alterations vertigo and vaginal dryness were significantly greater in group I. In group II a significant decrease in hot flushes, insomnia, nervousness, vaginal dryness, KI, and SUMEVA were found, as was a significant increase in endometrial thickness.
The treatment that is proposed in this study can constitute a temporary alternative during the period of transition from HT to raloxifene.
激素疗法(HT)是控制更年期症状的最佳选择之一;然而,女性在接受数年HT治疗后改用雷洛昔芬时,症状会再次出现。
评估在常规剂量雷洛昔芬基础上加用低剂量酯化共轭雌激素对控制更年期症状的效果。
对14名健康绝经后患者进行研究。在基线时以及治疗开始3个月后,通过库珀曼指数(KI)和使用模拟视觉量表SUMEVA进行的症状评估总和来评估更年期症状。记录所有人体测量变量,以及绝经时间和子宫内膜厚度。随机将她们分为以下几组:I)雷洛昔芬60毫克/天(n = 7)和II)雷洛昔芬60毫克/天加酯化共轭雌激素0.312毫克/天(n = 7)。
分别通过独立样本和配对样本的学生t检验确定组间差异以及基线与治疗结束时的差异。
人体测量变量和绝经时间方面无差异。治疗三个月后,I组的性欲改变、眩晕和阴道干燥情况明显更严重。II组潮热、失眠、紧张、阴道干燥、KI和SUMEVA显著降低,子宫内膜厚度显著增加。
本研究提出的治疗方法可在从HT过渡到雷洛昔芬的期间构成一种临时替代方案。