Ultrasonographic and morphological studies of the postmenopausal endometrium using unopposed estrogen replacement therapy with regular pause: a prospective preliminary study

Marisa Teresinha Patriarca, Geraldo Rodrigues de Lima, João N. Stávale, Wagner José Gonçalves, Vilmon de Freitas, José Maria Soares, Manuel de Jesus Simões, Edmund Chada Baracat
In: European Journal of Obstetrics & Gynecology and Reproductive Biology · 2001 · vol. 98(1) , pp. 119–123 · doi:10.1016/s0301-2115(01)00286-x · PMID:11516811 · W2084677816
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This prospective preliminary study examined the ultrasonographic and morphological changes in the postmenopausal endometrium of women receiving unopposed estrogen replacement therapy with regular pauses.

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Abstract

UnlabelledHormone replacement therapy with progestogen is known to have severe side effects or complications in certain patients.ObjectiveThe goal of this study is to evaluate the safety and efficacy of an alternative treatment regimen with a mensal pause using both transvaginal sonography (TVS) and endometrial biopsy to follow patients.MethodsA total of 30 postmenopausal women were treated with unopposed estrogen for 21 days each month followed by a regular pause of 9-10 days, and were studied prospectively for 18 months. The TVS measurements of endometrial thickness and biopsy of the endometrium were done on the 21st day of treatment and the 7th day of the pause at 6-month intervals throughout the study.ResultsThere was a significant decrease of proliferative activity at all three time points during the study (6, 12 and 18 months) when tested on the 7th pause day (PD7). The percentage of patients with hyperplasia without nuclear atypia and endometrial thickness > or =8mm was 32% at 6 months, but decreased to 22 and 19% at 12 and 18 months, respectively. All cases of hyperplasia regressed after the hormonal pause throughout the treatment period.ConclusionsThis study presents an alternative treatment regimen for select patients having side effects or complications from progestogen administration; however, studies evaluating the safety and efficacy of this regimen over longer time periods are necessary.

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