Cyclic-combined Conjugated Estrogens and Dydrogesterone in the Treatment of Postmenopausal Syndrome

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Abstract
We report the data concerning postmenopausal women treated either with a calcium supplement (500 mg/day, group l, n = 13) or with cyclic conjugated estrogens (0.625 mg/day) and dydrogesterone (5 mg/day) for 21 days with a 7-day free interval (n = 27, group 2) for 24 months. Withdrawal bleeding was regular, starting 1–2 days after the last treatment day and defined as light or mild. No sign of endometrial hyperstimulation was found by hysteroscopy and endometrial biopsy performed after 24 months of treatment. In group 1, constant levels of both urinary excretion of hydroxyproline and plasma osteo-calcin were observed, along with a significant (p < 0.05) decrease in vertebral bone mineral density. In group 2, both urinary excretion of hydroxyproline and plasma osteocalcin levels were significantly (p < 0.05) decreased and vertebral bone density showed a slight but significant (p < 0.05) increase. In group 1, a significant (p < 0.05) increase in serum low-density lipoprotein (LDL)-cholesterol levels was observed, whereas no modification in total cholesterol, high-density lipoprotein (HDL)-cholesterol and triglycerides was found. In group 2, total cholesterol and LDL-cholesterol levels significantly (p < 0.05) decreased, whereas triglycerides levels were stable throughout the study. In this group, HDL-cholesterol levels showed a significant (p < 0.05) increase. In conclusion, the regimen for cyclic combined estrogen-progestogen therapy attenuates bleeding disturbances and results in a low dropout rate. Thus, the clinical and metabolic actions, as well as the protective effects on the endometrium, make this treatment of potential interest. Further studies are required to confirm the long-term beneficial effects of this formula on cardiovascular protection and fracture rate.

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