Low and ultra low-dose estrogen therapy for climacteric symptom control--preliminary report.

Abstract

Introduction: Recent clinical trials have caused physicians to reconsider the use of hormone therapy (HT). Low-dose therapy has been proposed for those patients who tolerate standard doses poorly.

Objective: to evaluate low-dose and ultra low-dose estrogen therapy (ET) for vasomotor symptom control.

Materials and method: Thirty five healthy postmenopausal women with moderate to severe climacteric symptoms were recruited. Symptoms were evaluated at baseline and three months after the beginning of treatment by a modified Kupperman's index (KI). Endometrial thickness was assessed with pelvic ultrasonography. Patients were randomly assigned to one of these therapies: I) Esterified conjugated estrogens (ECE) 0.156 mg/day (ultra low-dose) (n = 18) or II) ECE 0.312 mg/day (low-dose) (n = 17) for 12 weeks. Statistical analysis was done with student's t test for independent and paired samples.

Results: In groups I and II, the abandon rate was 33.3% and 47.0%, respectively. No differences were found among the groups in general data nor in KI. The KI at the end of the study was 47.8+/-37.9 and 48.9+/-33.2 for group I and group II, respectively, for a mean decrease of 32.1% and 37% without differences between the groups. When comparing each group separately, KI decreased in group 1, but without statistical significance. In group II there was significant decrease in KI. Endometrial thickness increased from 2.5+/-1.0 to 4.2+/-1.7 mm in group I, and from 3.5+/-1.3 to 6.0 +/-1.4 mm in group II.

Conclusion: low dose and ultra-low dose ET were useful in decreasing climacteric symptoms.