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- Andersson, K, et al.
(författare)
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Intrauterine or oral administration of levonorgestrel in combination with estradiol to perimenopausal women--effects on lipid metabolism during 12 months of treatment
- 1996
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Ingår i: International Journal of Fertility and Menopausal Studies. - 1069-3130. ; 41:5, s. 476-483
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Limited data concerning serum lipids and lipoproteins are available on the effect of HRT in perimenopausal women, who commonly have marked bleeding disturbances and may have severe climacteric symptoms. Almost all previously published data have utilized a simplified form of lipoprotein analysis, which includes an estimation and not a determination of LDL cholesterol. To delineate the role of locally administered progestogen, perimenopausal women were studied for a year. PATIENTS AND METHODS: 40 perimenopausal women with climacteric complaints. The continuous release of low-dose levonorgestrel from an intrauterine device was used as progestogen co-medication to estradiol in a new type of continuous combined hormone replacement therapy. Women were randomized to either cyclical treatment with 2 mg of oral estradiol valerate in combination with 250 micrograms of levonorgestrel for the last ten days (Cyclo Progynova) or continuously with 2 mg estradiol valerate orally in combination with a 20 micrograms per 24 hour levonorgestrel releasing intrauterine device. RESULTS: Reduced HDL cholesterol was initially recorded in both treatment arms and disappeared after 1 year of treatment. Triglycerides were reduced in the orally treated group, but not in the device group. No changes in LDL cholesterol were noted. CONCLUSIONS: The findings suggest that continuous combined HRT with intrauterine release of 20 micrograms levonorgestrel per 24 hours in perimenopausal women is neutral as far as lipid metabolism is concerned, since no alterations compared with pretreatment values could be noted after 12 months of treatment. Less marked lipid changes were obtained in perimenopausal women as compared with data on postmenopausal women. Differences in methodology may partly account for this.
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| 2. |
- Heimer, G, et al.
(författare)
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Effects of vaginally delivered estrogens
- 1996
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. Supplement. - 0300-8835. ; 163, s. 1-2
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Atrophic condition in the vagina and lower parts of the urethral tract are common in elderly women. From population based surveys it has been estimated that 40% or more of women over 60 complain of insufficient control of micturation. In addition, lower urinary tract infections are common in this age group and recurrent cystitis is a scourge for many women (1, 2). Vaginal problems such as vaginal dryness, dyspareunia as well as infectious and non infectious disorders in the vagina may be even more common in elderly women (3) Vasomotor symptoms such as sweats and hot flushes commonly commence around the time of the menopause. In the majority of cases urogenital dysfunction does not become a problem until a decade later. Endogenous estrogens decline during the climacteric and the fall of estradiol levels from the time of onset of vasomotor symptoms until commencement of urogenital problems cannot be disregarded. In other words, it seems as if urogenital integrity can be maintained at lower estrogen levels than those required to resist vasomotor symptoms and conserve bone mass. Further evidence for this concept is achieved from numerous clinical studies in which various estrogens have been administered both orally and vaginally to elderly women with signs of urogenital atrophy which have resulted in amelioration. Such an alleviation of urogenital symptoms can be achieved without provoking endometrial growth.
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