Climacteric symptom control after the addition of low-dose esterified conjugated estrogens to raloxifene standard doses.

Sebastián Carranza-Lira, Ana Luz MacGregor Gooch, Nadia Saldivar, Max Saráchaga Osterwalder
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Abstract

Introduction: Hormone therapy (HT) is one the best options for climacteric symptom control; however when women are switched to raloxifene, after several years of HT, they restart with symptoms.

Objective: To evaluate the effect of the addition of low-dose esterified conjugated estrogens to the conventional dose of raloxifene in the control of climacteric symptoms.

Materials and methods: 14 healthy postmenopausal patients were studied. Climacteric symptoms were evaluated at baseline and 3 months after the beginning of treatment by the Kupperman's index (KI) and by the sum of the symptom evaluations carried out with an analog visual scale called SUMEVA. In all the anthropometric variables were documented, as well as time since menopause and endometrial thickness. At random they were distributed in some of the following groups: I) Raloxifene 60 mg/day (n=7) and II) Raloxifene 60 mg/day plus esterified conjugated estrogens 0.312 mg/day (n=7).

Statistical analysis: Differences among the groups, as well as those among baseline and those at the end of treatment, were determined by student's t test for independent samples and paired samples respectively.

Results: There were no differences in anthropometric variables, nor in the time since menopause. After three months of treatment the libido alterations vertigo and vaginal dryness were significantly greater in group I. In group II a significant decrease in hot flushes, insomnia, nervousness, vaginal dryness, KI, and SUMEVA were found, as was a significant increase in endometrial thickness.

Conclusion: The treatment that is proposed in this study can constitute a temporary alternative during the period of transition from HT to raloxifene.

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在雷洛昔芬标准剂量基础上添加低剂量酯化偶联雌激素后更年期症状的控制。
激素治疗(HT)是控制更年期症状的最佳选择之一;然而,当女性在接受了几年的激素疗法后转而使用雷洛昔芬时,她们又出现了症状。目的:评价在常规剂量雷洛昔芬基础上加用低剂量酯化偶联雌激素对更年期症状的控制效果。材料与方法:对14例健康绝经后患者进行研究。在基线和治疗开始后3个月,通过Kupperman指数(KI)和用模拟视觉量表SUMEVA进行的症状评估的总和来评估更年期症状。所有的人体测量变量,以及绝经后的时间和子宫内膜厚度都被记录下来。随机分为两组:1)雷洛昔芬60 mg/天(n=7); 2)雷洛昔芬60 mg/天加酯化偶联雌激素0.312 mg/天(n=7)。统计学分析:组间差异、基线与治疗结束差异分别采用独立样本和配对样本的学生t检验。结果:在人体测量变量上没有差异,绝经后的时间也没有差异。治疗3个月后,性欲改变,眩晕和阴道干燥在i组明显更大。在II组,潮热、失眠、神经紧张、阴道干燥、KI和SUMEVA明显减少,子宫内膜厚度显著增加。结论:本研究提出的治疗方案可构成从HT向雷洛昔芬过渡期间的临时替代方案。
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The paradox of obstetric "near misses": converting maternal mortality into morbidity. Climacteric symptom control after the addition of low-dose esterified conjugated estrogens to raloxifene standard doses. Update on ovarian hyperstimulation syndrome: part 2--clinical signs and treatment. Influence of adiposity on leptin, LH and androgen levels in lean, overweight and obese PCOS patients. Value of fetal echocardiography in diagnosis of congenital heart disease in a Serbian university hospital.
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