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Titolo:
HRT dosing regimens: Continuous versus cyclic - Pros and cons
Autore:
Shoupe, D;
Indirizzi:
Univ So Calif, Sch Med, Dept Obstet & Gynecol, Los Angeles, CA 90033 USA Univ So Calif Los Angeles CA USA 90033 Gynecol, Los Angeles, CA 90033 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF FERTILITY AND WOMENS MEDICINE
fascicolo: 1, volume: 46, anno: 2001,
pagine: 7 - 15
SICI:
1534-892X(200101/02)46:1<7:HDRCVC>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
HORMONE REPLACEMENT THERAPY; ESTROGEN-PROGESTIN REPLACEMENT; CORONARY HEART-DISEASE; BREAST-CANCER RISK; WOMEN RECEIVING ESTROGEN; POSTMENOPAUSAL WOMEN; ENDOMETRIAL CANCER; MEDROXYPROGESTERONE ACETATE; CONJUGATED ESTROGENS; COMBINED ESTRADIOL;
Keywords:
hormone replacement therapy; regimens; side effects; progestins;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
65
Recensione:
Indirizzi per estratti:
Indirizzo: Shoupe, D Womens & Childrens Hosp, Dept Obstet & Gynecol, 1240 N Mission Rd, Los Angeles, CA 90033 USA Womens & Childrens Hosp 1240 N Mission Rd Los Angeles CA USA 90033
Citazione:
D. Shoupe, "HRT dosing regimens: Continuous versus cyclic - Pros and cons", INT J F W M, 46(1), 2001, pp. 7-15

Abstract

The introduction of new products, lower dosages, and better continuous andcyclic regimens allows for individualized treatment aimed at minimizing risk and side effects, while maximizing confidence and compliance. Since the major side effect of HRT that discourages long-term use is vaginal bleeding, newer regimens are designed to minimize it. The lowest doses of estrogen currently approved by the FDA for prevention of osteoporosis include 0.3 mgesterified estrogens, 0.025 mug transdermal estradiol patch, and 0.5 mg micronized estradiol. In most naturally menopausal women or those over 65 years of age, conjugated estrogen 0.3 mg (with adequate calcium intake) is protective against bone loss and cardiovascular disease. These low doses are often used with cyclic progestins every 3 to 4 months. Advantages of cyclic therapy using low-dose estrogen include minimal progestin exposure, low rate of withdrawal bleeding, lowered side effects, and, often, higher comfort level. Cyclic estrogen regimens with higher doses have been in use longer, but they often necessitate more frequent progestin treatment and may resultin cyclic bleeding or breast tenderness. While HDL- and LDL-cholestcrol changes are greater and more beneficial during higher-dose oral cyclic therapy, the large increase in triglycerides is of concern. The most commonly used continuous combined regimens include conjugated estrogen plus daily progestin orally or the combination estradiol/norethindrone acetate transdermal patch. Continuous combined regimens are simple and easy-to-use, and are designed to minimize bleeding. Multiple studies suggest that the mechanism of benefit provided by estrogen goes beyond estrogen's favorable impact on lipoproteins, which is blunted by daily use of syntheticprogestins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 20:47:59