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Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on endometrial bleeding.

Abstract：

OBJECTIVE:To evaluate vaginal bleeding profiles with lower doses of conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA) as continuous combined therapy. DESIGN:The Women's Health, Osteoporosis, Progestin, Estrogen (Women's HOPE) study, a randomized, double-blind, placebo-controlled trial. SETTING:Study centers across the United States. PATIENT(S):Two thousand six hundred seventy-three healthy, postmenopausal women. INTERVENTION(S):Women received CEE, 0.625 mg/d; CEE, 0.625 mg/d, plus MPA 2.5 mg/d; CEE, 0.45 mg/d; CEE, 0.45 mg/d, plus MPA, 2.5 mg/d; CEE 0.45 mg/d, plus MPA, 1.5 mg/d; CEE, 0.3 mg/d; CEE, 0.3 mg/d, plus MPA, 1.5 mg/d; or placebo for 1 year. MAIN OUTCOME MEASURE(S):Bleeding data were analyzed in efficacy-evaluable and intention-to-treat populations. RESULT(S):Cumulative amenorrhea and no bleeding rates were higher with lower doses of CEE/MPA than with CEE 0.625/MPA 2.5. A linear trend between time since menopause and cumulative amenorrhea was observed (P<.05) in all CEE/MPA groups except the CEE 0.45/MPA 1.5 group. The proportion of patients who experienced no bleeding in cycle 1 was 89%, 82%, and 80% in the CEE 0.3/MPA 1.5, CEE 0.45/MPA 1.5, and CEE 0.45/MPA 2.5 groups, respectively. These values were significantly greater than the incidence of no bleeding in the CEE 0.625/MPA 2.5 group (P<.05). CONCLUSION(S):Lower-dose regimens of CEE and MPA produce higher rates of amenorrhea and no bleeding compared with CEE 0.625/MPA 2.5 and may be appropriate for newly menopausal patients.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Archer DF,Dorin M,Lewis V,Schneider DL,Pickar JH

doi

10.1016/s0015-0282(01)01792-7

keywords:

subject

Has Abstract

pub_date

2001-06-01 00:00:00

pages

1080-7

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(01)01792-7

journal_volume

75

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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