[Dihydrogesterone vs. medroxyprogesterone acetate in association with transdermal estradiol in postmenopausal substitution treatment]

Abstract

The authors consider postmenopausal replacement oestrogen therapy to be appropriate provided that in non-hysterectomised women it is associated with a progestin compound. For this purpose they studied the endometrial changes in women treated randomly with dihydrogesterone and medroxyprogesterone acetate. Having performed a pre-treatment biopsy, in order to include only those cases with hypotrophic endometrium or with residual proliferative activity, cyclical treatment was commenced with transdermic estradiol and dihydrogesterone or medroxyprogesterone acetate. An endometrial follow-up was performed after 6 months to control the maturation of the endometrium which was free from atypical transformations although medroxyprogesterone acetate was preferable due to its effects on the metabolism in general and because it allowed a higher percentage of conversion into secreting endometrium without evolving towards hyperplasia.