Raudaskoski T H, Lahti E I, Kauppila A J, Apaja-Sarkkinen M A, Laatikainen T J
Department of Obstetrics and Gynecology, Oulu University Hospital, Finland.
Am J Obstet Gynecol. 1995 Jan;172(1 Pt 1):114-9. doi: 10.1016/0002-9378(95)90095-0.
Our purpose was to study the effects of intrauterine release of a daily dose of 20 micrograms levonorgestrel by an intrauterine device on climacteric symptoms, bleeding pattern, and endometrial histologic features in postmenopausal women receiving transdermal estrogen replacement therapy.
Forty parous postmenopausal women were randomly allocated into two groups for 1 year: 20 women receiving a continuous transdermal daily dose of 50 micrograms of estradiol had a levonorgestrel-releasing intrauterine contraceptive device inserted, and the control group of 20 women received a continuous oral dose of 2 mg of estradiol valerate and 1 mg of norethisterone acetate daily. The climacteric symptoms, bleeding patterns, endometrial thickness, and endometrial changes in biopsy samples were analyzed. Serum levels of estradiol in both groups and levonorgestrel levels in the intrauterine device group were also determined.
Both treatment regimens effectively relieved climacteric symptoms. Spotting was more common in the intrauterine contraceptive device group than in the oral therapy group for the first 3 months. After that, the proportion of women without any bleeding was similar in both groups. Two patients in each group dropped out because of bleeding.
These preliminary findings suggest that the levonorgestrel-releasing intrauterine contraceptive device is a useful alternative mode of progestin administration for certain selected women receiving estrogen replacement therapy.
我们的目的是研究宫内节育器每日释放20微克左炔诺孕酮对接受经皮雌激素替代疗法的绝经后妇女的更年期症状、出血模式和子宫内膜组织学特征的影响。
40名经产妇绝经后妇女被随机分为两组，为期1年：20名接受每日50微克雌二醇持续经皮给药的妇女插入含左炔诺孕酮的宫内节育器，对照组20名妇女每日接受2毫克戊酸雌二醇和1毫克醋酸炔诺酮的持续口服给药。分析更年期症状、出血模式、子宫内膜厚度以及活检样本中的子宫内膜变化。还测定了两组的雌二醇血清水平以及宫内节育器组的左炔诺孕酮水平。
两种治疗方案均有效缓解更年期症状。在最初3个月内，宫内节育器组的点滴出血比口服治疗组更常见。此后，两组中无任何出血的妇女比例相似。每组有两名患者因出血退出研究。
这些初步研究结果表明，对于某些接受雌激素替代疗法的特定女性，含左炔诺孕酮的宫内节育器是一种有用的孕激素给药替代方式。
