Meuwissen J H, Wiegerinck M A, Haverkorn M J
Department of Gynecology, St Joseph Hospital, Veldhoven, The Netherlands.
Maturitas. 1995 Feb;21(2):121-5. doi: 10.1016/0378-5122(94)00867-7.
For 176 postmenopausal women on HRT with progestogen addition 'on demand' medroxyprogesterone acetate (MPA), noresthisterone and tibolone were used to protect the endometrium in 214 cases. Tibolone is a gonadomimetic steroid with combined progestogenic and estrogenic effects. In this study tibolone has been used as a progestogen. The results of these three progestogens were compared. The endometrial thickness before and after the use of progestogen was determined by vaginosonography. In 175 out of 214 cases progestogen addition during oestrogen therapy caused endometrial regression. Withdrawal bleeding was observed 166 times. If the endometrial thickness on the onset of progestogen addition was 5 mm or more, in nearly all cases withdrawal bleeding occurred when MPA or norethisterone was used. If tibolone was used, no withdrawal bleeding occurred in over half the cases studied. We report the first observation of induced endometrial regression without withdrawal bleeding.
对于176名接受激素替代疗法（HRT）且按需添加醋酸甲羟孕酮（MPA）的绝经后女性，使用炔诺酮和替勃龙在214例病例中保护子宫内膜。替勃龙是一种具有孕激素和雌激素联合作用的拟性腺类固醇。在本研究中，替勃龙被用作孕激素。比较了这三种孕激素的效果。使用孕激素前后的子宫内膜厚度通过阴道超声检查确定。在214例病例中的175例中，雌激素治疗期间添加孕激素导致子宫内膜消退。观察到撤退性出血166次。如果添加孕激素时的子宫内膜厚度为5毫米或以上，在几乎所有使用MPA或炔诺酮的病例中都出现了撤退性出血。如果使用替勃龙，在超过一半的研究病例中未出现撤退性出血。我们报告了首次观察到诱导子宫内膜消退而无撤退性出血的情况。
