Vaginal Bleeding Patterns on Continuous Combined Hormone Replacement Therapy using Micronized Progesterone in Postmenopausal Women

Park, Man Chul; Lee, Yeun Eun; Park, Choong Hak

Abstract

OBJECTIVE
The purpose of this study is to evaluate the patterns of vaginal bleeding on continuous combined hormone replacement therapy (HRT) with micronized progesterone (MP), compared with medroxyprogesterone acetate (MPA) and to find any effects of body weight, body mass index, age of menopause, and duration of postmenopausal amenorrhea on these patterns of vaginal bleedings.
METHODS
In continuous combined HRT using MP, 0.625 mg conjugate equine estrogen (CEE) and 100 mg MP were daily administered orally in 100 postmenopausal women. In continuous combined HRT using MPA, 0.625 mg CEE and 2.5 mg MPA were daily administered orally in 70 postmenopausal women. And we observed the vaginal bleeding patterns for six months after initiation of therapy.
RESULTS
No vaginal bleeding or only slight vaginal spotting within 3 months were in 92 women (92%) in continuous combined HRT using MP. Only 8 women (8%) showed continuous bleeding for more than three months or heavy bleeding, so they stopped HRT or changed to other regimens. These were statistically significant lower rates of frequency of vaginal bleeding (35%) and drop out (8%), compared with the group using MPA (62.9%, and 42.9%) in our previous study. There were no statistically significant differences in the means of body weight, body mass index, and age of menopause between two treatment groups, but the mean of durations of postmanopausal amenorrhea was significantly longer in MP treatment group than that of MPA treatment group. In each treatment group, there were no statistically significant differences in the means of body weight, body mass index, duration of postmanopausal amenorrhea, and age of menopause according to the frequency of vaginal bleeding.
CONCLUSION
Continuous combined HRT using MP showed less bleeding and better compliance than that using MPA.