Treatment of dysfunctional uterine bleeding in the perimenopause: The effects of adding combined estradiol/norethisterone acetate therapy to goserelin acetate treatment – a randomized, placebo-controlled, double-blind trial

Henk R. Franke, H. Franke, F. Froukje Snaaijer, Paul W. H. Houben, Marius J. van der Mooren
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2006 · vol. 22(12) , pp. 692–697 · doi:10.1080/09513590601015101 · PMID:17162712 · W2018949829
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Adding combined estradiol/norethisterone acetate to goserelin acetate for dysfunctional uterine bleeding in perimenopausal women prevented bone mineral density loss and improved climacteric complaints without adverse effects.

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Abstract

OBJECTIVE: To assess the effects of adding combined estradiol/norethisterone acetate therapy (CENT) to goserelin acetate treatment (GA) of dysfunctional uterine bleeding (DUB) in perimenopausal women. METHODS: In a randomized, placebo-controlled, double-blind trial followed by an open follow-up study, 31 perimenopausal women with DUB were recruited from gynecological outpatient departments of two Dutch hospitals and randomized for treatment with either GA/placebo or GA/CENT for 6 months followed by 18 months of GA/CENT for all. The main outcome measures were abdominal pain, number of bleeding days, double-layer endometrial thickness (DET), Greene climacteric score (GCS), visual analog scale for well-being, bone mineral density (BMD) and mammographic density (BI-RAD score). RESULTS: Abdominal pain, number of bleeding days and DET decreased in both groups, the between-group difference in decrease not being statistically significant. GCS initially showed significant improvement in the GA/CENT group. BMD decreased significantly in the GA/placebo group (-4.1%) compared with the GA/CENT group (-0.3%). Another 18 months of GA/CENT did not result in a lasting difference in BMD between groups. BI-RAD scores did not differ significantly between or within the two groups. CONCLUSIONS: Adding CENT to GA treatment for DUB in perimenopausal women initially prevented BMD loss and improved climacteric complaints, while having no negative impact on vaginal bleeding, abdominal pain or BI-RAD scores. However, prolonged treatment did not result in a lasting prevention of bone loss.

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