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A five year prospective study of oral oestriol succinate therapy
138
74
POST-MENOPAUSAL OESTROCEN REPLACEMENT: PREVENTION OF
OSTEOPOROSIS AND
SYSTEMIC EFFECTS
Fred W. Lafferty and Dennis 0. Helmuth - Cleveland, Ohio, U.S.A.
The
long-term effects of
oestrogen replacement in
ambulatory post-menopausal women were
initially healthy and
assessed in 61 oestrogen-treatedand 63
control subjects who were followed up prospectively for 3 to 16 years (a mean of years). Oestrogens were given as conjugated equine oestrogen 0.6 mg daily
8.6
for three out of every four weeks. Neither progestogens nor
calcium supplements
were given and no attempt was made to change the pattern of physical activity in either group. Complete physical examinations and
laboratory screening were
performed every one to two years in all subjects.
A loss of height of 1.3 cm (one-half inch) or
more
developed with
twice the
frequency among the control as compared with the oestrogen-treatedsubjects, the major difference appearing after 65 years of age. However, oestrogen replacement was
not
found to be an absolute protection against height loss, especially after
TO years of age. Ninety-five percent of the sudden losses of height were
free of
pain. Myocardial. infarctions and abnormal electrocardiogramswere significantly reduced in the oestrogen group as compared with the control group, but observations are needed. Long-term oestrogen replacement in
further
port-menopausal
women reduces the development of spinal osteoporosis and may reduce the development of ischaemic heart disease.
75
A FIVE YEAR PROSPECTIVE STUDY OF ORAL OESTRIOL SUCCINATE THERAPY
C. Lauritzen - Ulm, F.R.G.
A
five year prospective multicenter study involving 911 patients with typical
climacteric complaints was conducted. All patients had their menopause at one
year ago, had
received no
least
hormonal treatment in the past six months and
received no other interfering therapy. All patients received 2-6 mg (mean: 4 of oestriol succinate orally.
The
treatment proved to
be
mg)
effective for vasomotor (hot flushes improved in
80%), urogenital and psychiatric symptoms. Side effects (gastrointestinal, edema
139
or
painful breasts) were
rare as
was uterine bleeding CO.&4%). All patients
with uterine bleeding underwent endometrial biopsy, never revealing hyperplasia or
endometrial cancer. Moderate hypertension requiring therapy occurred in two
women, while half of the study population showed a unchanged diastolic blood pressure. Mean period. Two women suffered mild and
decreased cystolic and
an
body weight decreased over the study
short lasting thrombophlebitis, while two
other women developed breast carcinoma; one after three months and one after two years. Certainly the first case is other malignancies were
unrelated to
the
oestrogen treatment. Two
observed: one cervical carcinoma (after six months) and
one tumour of the small intestine.
Of the
911
women.in the study group 754 dropped out of the trial, leaving 177
women still within. Total women
years observed were 3412. Reasons for leaving
the trial were: 45 because of complaints which in about half could be to
the
therapy; 21
attributed
patients experienced insufficient therapeuticaleffect; 65
because they were free of symptoms; 13 wanted no
more medication and
113 for
various reasons, e.g. warnings of friends or doctors against oestrogens . In two patients therapy had to be withdrawn because they developed hepatitis during the treatment.
This
study shows that treatment of
succinate is
effective and
safe and
climacteric complaints with oestriol thus suitable for
long term oestrogen
replacement therapy.
76
CALENDAR-ORIENTEDCOMPLIANCE
Dawn A. Leonard and Walter G. Leonard - Melrose, Massachusetts, U.S.A.
Poor patient compliance with therapeutic regimens is becoming an
impediment to
successful medical treatment. Numerous studies have replicated data which show, according to conservative estimates, that there is some form of
noncompliance in
one-third to one-half of all patients [l-3].
Our
study was
aimed at
improving the
replacement therapy (ERT) among women research sample was
therapeutic effect of
oestrogen
suffering from menopausal symptoms. The
derived from the private obstetrioslgynaecologypractice of
one of the researchers.
74
POST-MENOPAUSAL OESTROCEN REPLACEMENT: PREVENTION OF
OSTEOPOROSIS AND
SYSTEMIC EFFECTS
Fred W. Lafferty and Dennis 0. Helmuth - Cleveland, Ohio, U.S.A.
The
long-term effects of
oestrogen replacement in
ambulatory post-menopausal women were
initially healthy and
assessed in 61 oestrogen-treatedand 63
control subjects who were followed up prospectively for 3 to 16 years (a mean of years). Oestrogens were given as conjugated equine oestrogen 0.6 mg daily
8.6
for three out of every four weeks. Neither progestogens nor
calcium supplements
were given and no attempt was made to change the pattern of physical activity in either group. Complete physical examinations and
laboratory screening were
performed every one to two years in all subjects.
A loss of height of 1.3 cm (one-half inch) or
more
developed with
twice the
frequency among the control as compared with the oestrogen-treatedsubjects, the major difference appearing after 65 years of age. However, oestrogen replacement was
not
found to be an absolute protection against height loss, especially after
TO years of age. Ninety-five percent of the sudden losses of height were
free of
pain. Myocardial. infarctions and abnormal electrocardiogramswere significantly reduced in the oestrogen group as compared with the control group, but observations are needed. Long-term oestrogen replacement in
further
port-menopausal
women reduces the development of spinal osteoporosis and may reduce the development of ischaemic heart disease.
75
A FIVE YEAR PROSPECTIVE STUDY OF ORAL OESTRIOL SUCCINATE THERAPY
C. Lauritzen - Ulm, F.R.G.
A
five year prospective multicenter study involving 911 patients with typical
climacteric complaints was conducted. All patients had their menopause at one
year ago, had
received no
least
hormonal treatment in the past six months and
received no other interfering therapy. All patients received 2-6 mg (mean: 4 of oestriol succinate orally.
The
treatment proved to
be
mg)
effective for vasomotor (hot flushes improved in
80%), urogenital and psychiatric symptoms. Side effects (gastrointestinal, edema
139
or
painful breasts) were
rare as
was uterine bleeding CO.&4%). All patients
with uterine bleeding underwent endometrial biopsy, never revealing hyperplasia or
endometrial cancer. Moderate hypertension requiring therapy occurred in two
women, while half of the study population showed a unchanged diastolic blood pressure. Mean period. Two women suffered mild and
decreased cystolic and
an
body weight decreased over the study
short lasting thrombophlebitis, while two
other women developed breast carcinoma; one after three months and one after two years. Certainly the first case is other malignancies were
unrelated to
the
oestrogen treatment. Two
observed: one cervical carcinoma (after six months) and
one tumour of the small intestine.
Of the
911
women.in the study group 754 dropped out of the trial, leaving 177
women still within. Total women
years observed were 3412. Reasons for leaving
the trial were: 45 because of complaints which in about half could be to
the
therapy; 21
attributed
patients experienced insufficient therapeuticaleffect; 65
because they were free of symptoms; 13 wanted no
more medication and
113 for
various reasons, e.g. warnings of friends or doctors against oestrogens . In two patients therapy had to be withdrawn because they developed hepatitis during the treatment.
This
study shows that treatment of
succinate is
effective and
safe and
climacteric complaints with oestriol thus suitable for
long term oestrogen
replacement therapy.
76
CALENDAR-ORIENTEDCOMPLIANCE
Dawn A. Leonard and Walter G. Leonard - Melrose, Massachusetts, U.S.A.
Poor patient compliance with therapeutic regimens is becoming an
impediment to
successful medical treatment. Numerous studies have replicated data which show, according to conservative estimates, that there is some form of
noncompliance in
one-third to one-half of all patients [l-3].
Our
study was
aimed at
improving the
replacement therapy (ERT) among women research sample was
therapeutic effect of
oestrogen
suffering from menopausal symptoms. The
derived from the private obstetrioslgynaecologypractice of
one of the researchers.