van der Mooren M J, Hanselaar A G, Borm G F, Rolland R
Department of Obstetrics and Gynecology, University Hospital Nijmegen Sint Radboud, Nijmegen, The Netherlands.
Maturitas. 1994 Dec;20(2-3):175-80. doi: 10.1016/0378-5122(94)90014-0.
To describe changes in the withdrawal bleeding pattern and endometrial histology during a sequential 17 beta-estradiol-dydrogesterone regimen in postmenopausal women.
Open-label, non-comparative, prospective study.
Gynecological outpatient department of a university hospital.
Twenty-seven healthy non-hysterectomized postmenopausal women.
Continuous micronized 17 beta-estradiol supplementation, 2 mg daily, and cyclic administration of dydrogesterone, 10 mg daily for the first half of each 28 day treatment cycle.
Changes in the characteristics of the withdrawal bleeding pattern and the endometrial biopsy histology during 2 years of treatment.
The initial withdrawal bleeding was comparable to normal menstruation with respect to amount and duration. During the 2 years of treatment the bleeding showed a significant tendency to become shorter with less blood loss. This was mainly the result of the decrease (P < 0.001) in the number of days per cycle with bleeding grade II (normal menstruation). None of the women developed endometrial hyperplasia, and in almost all women the given hormone replacement therapy regimen induced secretory or atrophic changes of the endometrium.
This sequential 17 beta-estradiol-dydrogesterone regimen can be regarded as safe with respect to the prevention of endometrial disease and appeared to foster patient compliance.
描述绝经后女性在序贯使用17β-雌二醇-地屈孕酮方案期间撤退性出血模式和子宫内膜组织学的变化。
开放标签、非对照、前瞻性研究。
大学医院妇科门诊。
27名健康的未行子宫切除术的绝经后女性。
持续补充微粒化17β-雌二醇，每日2mg，以及周期性给予地屈孕酮，在每个28天治疗周期的前半周期每日10mg。
治疗2年期间撤退性出血模式特征和子宫内膜活检组织学的变化。
初始撤退性出血在出血量和持续时间方面与正常月经相当。在2年治疗期间，出血呈现出明显的缩短趋势，失血量减少。这主要是由于每个周期中出现Ⅱ级出血（正常月经）的天数减少（P<0.001）。所有女性均未发生子宫内膜增生，并且几乎所有女性使用的激素替代治疗方案均导致子宫内膜出现分泌期或萎缩性变化。
就预防子宫内膜疾病而言，这种序贯17β-雌二醇-地屈孕酮方案可被视为安全的，并且似乎有助于提高患者的依从性。
