Progestational effects of combinations of gestodene on the postmenopausal endometrium during hormone replacement therapy

OBJECTIVE: The aim of the study was to assess the dose-response effects on the postmenopausal endometrium of 3 sequential combined hormone replacement regimens and 1 continuous combined hormone replacement regimen of estradiol and gestodene. STUDY DESIGN: In this 2-year double-blind, placebo-controlled study, 278 healthy postmenopausal women received either 2 mg estradiol sequentially combined with 50 mu g or 25 mu g gestodene, 1 mg estradiol sequentially or continuously combined with 25 mu g gestodene, or placebo. RESULTS: All 4 hormone treatment regimens produced a safe endometrial histologic appearance. The regimens that were based on the fewer dose of 1 mg estradiol was associated with less uterine bleeding than were those that were based on 2 mg estradiol. For sequentially opposing the 2 mg dose of estradiol, the dose of 25 pg gestodene was less efficient in producing secretory activity than was the dose of 50 mu g gestodene. The measurement of placental protein 14 in serum reflected the secretory transformation of the endometrial buildup. CONCLUSION: The reduction in bleeding episodes associated with regimens with tower estradiol doses may lead to improved long-term therapy compliance by menopausal women. The potency of progestogens can be assessed by measuring the serum concentration of placental protein 14.