The Recent Clinical Observation Of HRT In Postmenopausal Women

Object To explore the effects of different kinds and doses of HRT on the Kupperman appraisal,exfoliative cytology of the vagina , size of the uterus and the thickness of the endometrium .method From healthy postmenopausal women who has come to our out-patient and who has inquired about menopausal symptoms and asked for HRT in our or other hospitals from June to December in 2003, we selected 39 women(mean age 53.13±4.75,menopause period 4.81±3.66 years),which all conformed to the following levels:did not take hormonal drugs in the last six months;normal through abdomen ultrasound;did not have vaginal bleeding of unknown reason or abnormal thickeness of the endometrium;was excluded of mammary benign and malignant disease;did not have cardiovascular,thromboembolism disease,acute liver and kidney disease,hypertension,gallbladder disease,diabetes,and were excluded of vaginitis .They were divided into 3 groups randomly:the first group were given conjugated estrogen 0.625mg daily,25 days as one period, they should use 3 periods, to those menopause period <3 years we used cylic sequential therapy ,each case was given extra medroxyprogesterone (4mg) daily in the last 14 days,to those >3 years we used continuous combined therapy,each case was given medroxyprogesterone (4mg) daily in each day;the second group were given conjugated estrogen 0.3mg daily,25 days as one period,they should also use 3 periods;the third group were given Livial,the whole time was 90 days,2.5mg daily in the first period,then 1.25mg in the following two periods.We conducted Kupperman appraisal,exfoliative cytology appraisal of the vagina,measured the size of the uterine and the thickness of the endometrium by color ultrasound before and after the usage.result　The results shows:①.After HRT,the climacteric symptoms of the three groups were improved significantly (p<0.01),it was particularly efficient to vasomotive heat and sweat,insomnia,fidget,fatigue.②Vaginal exfoliative cytology:two doses of the conjugated estrogen could improve the vaginal cytology appraisal significantly (p<0.01),especially in the high dose group,but livial did not have this influence on the cytology when taken in a short period.③.Bulk of the uterine: two doses of conjugated estrogen both had significant effect on the bulk of the uterine(p<0.01),but livial could not do it when taken in a short period.④Endometrium of the uterine:the thickness of the endometrium both increased in the three groups,especially in the conjugated estrogen of 0.625mg group,but the difference was not significant stastically.conclusion　 ①. HRT is a effective method to those women who have acute climacteric symptoms and don't have contraindications of using hormone,it can relieve climacteric symptoms significantly in a short period without apparent complications.②. Low dose of estrogen when used in a short time can not influence endometrium significantly,when adding the dose of estrogen, adding progesterone can also thicken the endometrium,so we should enhance the observation of the endometrium. Low dose of estrogen simply can enlarged the bulk of the uterine and improved the exfoliative cytology of the vagina significantly.③.Conjugated estrogen of 0.3mg is a efficient dose ,it is ecomonic,safe,and has little side effect,and can be popularized easily.④.Livial has low estrogenic,progesteric and androgenic activity,it don't have endometrium-stimulating effect,the happeness of the vaginal bleeding is low through clinical observation,the effect on the bulk of the uterine and the exfoliated cytology of the vagina is also little,it's a HRT drug close to ideal,and it's especially fit for postmenopause women.