INDUCTION AND MAINTENANCE OF DECIDUAL CHANGES WITH PROGESTERONE AND ESTROGEN

Abstract

Ten women, 25-35 years of age, with normal menstrual periodicity, one with premature menopause, and one with endometrial hyperplasia were selected for this study. Endometrial biopsies were performed each week in the cycles before, during and after treatment. As far as possible the following daily dosages were given to each patient (1) 25 mg. progesterone, (2) 25 mg. progesterone with 2.5 mg. estrogen, (3) 2 or 5 mg. estrogen, (4) 10 mg. progesterone with i mg. estrogen. Each course of treatment was started in the secretory (luteal) phase of a menstrual cycle and was continued until the 1st or 2d day after the onset of bleeding. Daily doses of 25 mg. of progesterone combined with 2.5 mg. of estrogen del?yed the onset of the expected menstrual period from 3 to 6 weeks and induced and maintained decidual changes in the endometrium. Smaller doses (10 mg. of progesterone with 1 mg. of estrogen) did not have this effect. When the 2 women with abnormal ovarian function were given adequate preliminary estrogen, daily doses of 25 mg. of progesterone with 2.5 mg. of estrogen induced the normal sequence of secretory changes during the first 2 weeks of treatment; then the decidual changes became evident during the 3d week of therapy. Daily doses of 25 mg. of progesterone or doses of 2 to 5 mg. of estrogen given to the women with normal cycles did not delay the onset of an expected menstrual period or induce any decidual changes in the endometrium.