Comparison of a transdermal continuous combined and an interrupted progestogen HRT

ObjectivesPilot study to compare the effects of a continuous combined hormone replacement therapy (HRT) regimen with an interrupted progestogen regimen administered transdermally, upon the endometrium of postmenopausal women, the incidence of amenorrhoea and relief of menopausal symptoms.MethodsFifty-nine postmenopausal women aged 50–63 years were randomised to either (i) continuous combined regimen: combined oestrogen/progestogen skin patches (releasing continuous 50 μg estradiol and 20 μg levonorgestrel/day) or (ii) interrupted regimen: oestrogen-only patches (releasing 80 μg estradiol/day) for 4 days followed by combined oestrogen/progestogen patches (releasing continuous 50 μg estradiol and 20 μg levonorgestrel/day) for 3 days, for 6 months. An endometrial biopsy was performed at end of treatment for histological analysis.ResultsThirty-three women (56%) completed the study. Significantly higher rates of amenorrhoea were observed with the interrupted than continuous combined regimen (P < 0.0001; 25% versus 7% at 6 months). The interrupted regimen was also associated with fewer days of bleeding overall (total 20 versus 44 days during months 4–6; P = 0.001). Both regimens improved vasomotor symptoms. No endometrial hyperplasia or atypical changes were observed in endometrial biopsies.ConclusionsAlthough significantly less bleeding was observed with the interrupted regimen, it did not have a sufficiently high incidence of amenorrhoea to render it clinically useful.