ENDOCRINE AND METABOLIC EFFECTS OF LOW-DOSE ESTROGEN PROGESTIN TREATMENT IN CLIMACTERIC WOMEN

Abstract

In a double-blind clinical trial with 31 premenopausal women suffering from climacteric symptoms, 16 (group A) were treated with an estrone (sodium estrone sulfate 1.5 mg)-noethisterone (5 mg) combination, and 15 (group B) were treated with an estrone-megestrol acetate (5 mg) combination. These treatments effectively alleviated climacteric symptoms without causing any bleeding disorders or pathological changes in the cytology of the uterine cervix or endometrium. In groups A and B, respectively, postovulatory progesterone concentrations above 5 nmol/l were found in 6 and 5 patients before, in 5 and 7 patients during, and in 2 and 4 patients after the treatments. Serum levels of luteinizing hormone and FSH decreased significantly and testosterone decreased slightly during both treatments. Serum cholesterol [P < 0.01) and high-density lipoprotein cholesterol (P < 0.001) in group A decreased during the treatment; only the high-density lipoprotein cholesterol values (P < 0.05) decreased in group B. Because of the minor endocrine and metabolic changes without any significant difference between the progestins, both norethisterone acetate and megestrol acetate seem to be suitable for estrogen-progestin combinations aimed at alleviating climacteric symptoms.