The effects of continuous combined transdermal oestrogen-progestogen treatment on bleeding patterns and the endometrium in postmenopausal women

Continuous transdermal oestrogen and interrupted progestogen as a novel bleed‐free regimen of hormone replacement therapy for postmenopausal women

“…Our results are also comparable with the reported incidence of amenorrhoea at six months with the currently available oral continuous combined oestrogen‐progestogen regimes 21 . A recent study has also reported similar rates of amenorrhoea with continuous oestrogen and progestogen administered transdermally 11 . However, compared with continuously administered progestogen, interrupted administration results in lower total dosage of progestogen which may possibly confer a ‘better’ lipid profile and lessen the incidence of side effects attributed to the progestogen component.…”

“…To avoid bleeding and improve acceptance and compliance, an HRT regime of continuous oestrogen and progestogen may be used, the aim being to render the endometrium atrophic and induce amenor‐rhoea. Although effective in the long term this regime may be associated with troublesome breakthrough bleeding particularly within the first six months of use 10,11 . Continuous administration of an oestrogen and interrupted administration of a progestogen has also been described 12 .…”

Climodien®(estradiol valerate 2 mg plus dienogest 2 mg) is safe and effective in the treatment of postmenopausal complaints

“…The often profuse nature of this bleeding, in addition to unpredictable spotting, is inconvenient and frequently unacceptable to patients, leading to compliance problems. Continuous combined HRT is taken daily throughout the 28-day cycle and carries the benefits of less intense bleeding in the initial stages, leading to amenorrhea in many patients within a few months 12 .…”

Bleeding patterns during continuous estradiol with different sequential progestogens therapy

“…The combined continuous schedule generally leads to amenorrhea and has been reported to offer better compliance, particularly in elderly patients. [15][16][17][18][19] The sequential continuous regimen is one of the most often prescribed, and is particularly suited for younger women in the first postmenopausal years because it has been reported to lead to monthly withdrawal bleeding in the majority of cases. 17,18,20,21 However, this regimen is often associated with irregular bleeding and intermenstrual spotting, which can lead to reduced compliance.…”