Endometrial Morphology after Sequential Medication with Mestranol and Chlormadinone

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Abstract
Thirty-nine regularly ovulating and menstruating women received sequential medication in 49 cycles with mestranol, 80 [mu]g daily from the 5th day of a cycle; chlormadinone 2 mg daily was added on the 16th day, and both steroids withdrawn simultaneously after the 25th day. The regimen was continued for as long as 7 cycles. Of 80 endometrial biopsies adequate for evaluation, 61 (76%) showed a secre-tory pattern, retarded on the average by 5-6 days from the normal pattern for the cycle day of biopsy. Eight biopsies (10%) showed an undatable secretory pattern; only 2 biopsies (2.5%) showed a suppressed pattern. The remaining biopsies revealed estrogenic effects. A predecidual reaction was present in 5 of the 60 biopsies taken on the 23d day or later, and development of spiral arterioles was almost uni-formly inhibited. Ectatic venules were not seen. The relation of this pattern of endometrial response to the antifertility properties of the regimen is discussed, and the time-dose effects of mestranol-chlor-madinone regimens are outlined.