A comparative study of the effects of an estradiol-releasing vaginal ring combined with an oral gestagen versus transdermal estrogen combined with a levonorgestrel-releasing IUD: clinical findings and endometrial response
Kalogirou, D.; Antoniou, G.; Karakitsos, P.; Kalogirou, O.; Antoniou, D.; Giannikos, L.
International Journal of Fertility and Menopausal Studies 41(6): 522-527
1996
ISSN/ISBN: 1069-3130 PMID: 9010746 Document Number: 458070
At the outpatient obstetric-gynecologic clinic of Areteion Hospital in Athens, Greece, 56 postmenopausal women, 48-76 years old and with signs and symptoms of estrogen deficiency-induced atrophic vaginitis, were randomly assigned to either the group using a silicon vaginal ring containing 2 mg micronized 17-beta- estradiol and oral medroxyprogesterone acetate for 7 days at the beginning of each month (group A) or the group using a combination of 50 mcg estradiol via a transdermal patch and a levonorgestrel-releasing IUD (group B). The women were using these regimens for 12 months. The purpose of the study was to compare the clinical and endometrial effects of the new vaginal ring with an oral progestin with those of the established hormone replacement regimen of transdermal estrogen and a levonorgestrel-releasing IUD. Vaginal ultrasound and pathologic examination of uterine curettage samples were used to determine endometrial effects. The urogenital complaints of all 56 women disappeared. The mean endometrial thickness before treatment was similar for both groups (2.9 mm for group A and 3 mm for group B) and was not significantly different than endometrial thickness after treatment (2.6 and 2.8 mm, respectively). Endometrial proliferation was not observed. The mean endometrial thickness at baseline predicted normal endometrium. After 3 months of treatment, vaginal bleeding patterns were similar in both groups. These findings confirm that both regimens effectively treat estrogen deficiency-induced urogenital disorders and do not increase the risk of endometrial proliferation.