Doğal menopozda olan olgularda pulse östrojen-medroksiprogesteron asetat kombinasyonu ve konjuge östrojen-medroksiprogesteron asetat ile yapılan hormon replasman tedavilerinin vazomotor yakınmalara ve uterin kanamalara olan etkilerinin karşılaştırılması
Küçük Resim Yok
Tarih
2005
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Doğal menopozda olan olgularda pulse östrojen-medroksiprogesteron asetat (MPA) ve konjuge östrojen-medroksiprogesteron asetat ile yapılan hormon replasman tedavilerinin vazomotor yakınmalara ve uterin kanama paternlerine olan etkilerinin karşılaştırılması. MATERYAL ve METOD: Çalışmaya Ege Üniversitesi Menopoz Polikliniği'ne Ocak 2002-Ocak 2004 tarihleri arasında başvuran ve doğal menopozda olan ve istenilen hormonal rejimi kullanmakta olan toplam 80 hasta dahil edildi. Çalışma retrospektif olarak olguların menopoz polikliniği kartları taranarak ve klinik bilgilerine ulaşılarak yapıldı. Çalışmaya dahil edilen hastaların kullanmakta oldukları hormon replasman tedavisi preperatları, Pulse östrojen-MPA olarak östradiol hemihidrat (aerodiol, 150 mcg, Servier) ve medroxyprogesteron asetat (Farlutal, 5 mg, Deva) preperatları ve konjuge östrojen-MPA olarak ise östrojen 0,625 mg ve medroksiprogesteron asetat 5 mg (Premelle Cycle, Wyeth) preperatıydı. Pulse östrojen-MPA grubunda 30 olgu, konjuge östrojen-MPA grubunda ise 50 hasta mevcuttu. BULGULAR: Başvuran hastaların yaş ortalaması 50.9±2.5'tu. Gruplar arasında yaş, menopoza girme yaşı, vücut kitle indeksi ve menopoz süresi bakımlarından istatistiksel olarak anlamlı farklılık saptanmadı (p>0.05). Sıcak basmaları sıklığı (ortalama 8.60±3.23) açısından istatistiksel olarak anlamlı farklılık saptanmadı (p>0.05). Uygulanan tedavi şekillerinin Kupperman indeksleri karşılaştırıldığında (pulse östrojen-MPA için sırasıyla bazal, 3. ve 6. aylardaki indeks değerleri 27.3±4.8; 10.2±2.9; 9.8±2.7'yken konjuge oral östrojen-MPA için 27.9±3.9; 10.5±2.3 ve 10.2±2.1 şeklinde) her iki grup arasında anlamlı farklılık saptanmadı (p>0.05). Çekilme kanaması olan hastaların her iki hormon replasman tedavisi rejimine göre dağılımlarına bakıldığında oral konjuge östrojen-MPA alan hastalarda sayıca daha fazla rastlanmakla birlikte her iki grup arasında anlamlı farklılık izlenmedi (p=0.061). Çekilme kanaması dışındaki her tür kanama paterni düzensiz kanama olarak kabul edildi. Düzensiz kanaması olan hastaların her iki hormon replasman tedavisi rejimine göre dağılımında yine oral konjuge östrojen-MPA grubunda sayıca daha fazla rastlanmakla birlikte gruplar arasında anlamlı fark bulunmadı (p=0.426). SONUÇ: Doğal menopozda olan hastalarda pulse östrojen-MPA tedavisinin etkinlik ve tolerabilitesi, oral konjuge östrojen-MPA tedavisine benzerdir ve etkin bir tedavi seçeneği olarak kullanılabilir.
OBJECTIVE: The comparison of the effects of hormone replacement therapy with pulse estrogen-medroxyprogesterone acetate and conjugated estrogene-medroxyprogesterone acetate on vasomotor complaints and uterine bleeding patterns in physiologic postmenopausal patients. STUDY DESING: Total 80 cases who were admitted to Ege University Medical Faculty Gynecology Department's Menopause Clinic between January 2002-January 2004 and using these regimens were included for this retrospective study. The hormone replacement therapy preperations which were the subject of this study were : the combination of estradiol hemihydrate (aerodiol, 150 mcg, Servier) and medroxyprogesterone acetate (Farlutal, 5 mg, Deva) as pulsed estrogen-MPA and estrogen 0,625 mg and medroxyprogesterone acetate 5 mg (Premelle Cycle, Wyeth) as conjugated estrogen-MPA combination. There were 30 cases in pulsed estrogen-MPA group and 50 patients in conjugated estrogen-MPA group. RESULTS: The average age of the patients was 50.9±2.5 years. There were no significant difference between the age, menopausal age, body-mass index (BMI) and postmenopausal period of the groups (p>0.05). There were no significant difference in hot flush frequencies (average 8.60±3.23) (p>0.05). Kupperman index values on initial, third and sixth months were 27.3±4.8; 10.2±2.9 ; 9.8±2.7 in pulsed estrogene-MPA group and 7.9±3.9 ; 10.5±2.3 ve 10.2±2.1 in conjugated estrogen-MPA group and no significant difference were found between the groups (p>0.05). The withdrawal bleeding was seen more frequently in oral conjugated estrogen-MPA group. But the difference was not significant (p=0.061). In the same way, the irregular bleeding (every bleeding pattern except withdrawal bleeding) episodes were seen in conjugated estrogen-MPA group more than the other group but, the difference was not significant (p=0.426). CONCLUSION: The efficacy and tolerability of pulse estrogene-MPA therapy in physiological postmenopausal patients was similar to oral conjugated estrogene-MPA therapy and could be used as an effective therapeutic choice.
OBJECTIVE: The comparison of the effects of hormone replacement therapy with pulse estrogen-medroxyprogesterone acetate and conjugated estrogene-medroxyprogesterone acetate on vasomotor complaints and uterine bleeding patterns in physiologic postmenopausal patients. STUDY DESING: Total 80 cases who were admitted to Ege University Medical Faculty Gynecology Department's Menopause Clinic between January 2002-January 2004 and using these regimens were included for this retrospective study. The hormone replacement therapy preperations which were the subject of this study were : the combination of estradiol hemihydrate (aerodiol, 150 mcg, Servier) and medroxyprogesterone acetate (Farlutal, 5 mg, Deva) as pulsed estrogen-MPA and estrogen 0,625 mg and medroxyprogesterone acetate 5 mg (Premelle Cycle, Wyeth) as conjugated estrogen-MPA combination. There were 30 cases in pulsed estrogen-MPA group and 50 patients in conjugated estrogen-MPA group. RESULTS: The average age of the patients was 50.9±2.5 years. There were no significant difference between the age, menopausal age, body-mass index (BMI) and postmenopausal period of the groups (p>0.05). There were no significant difference in hot flush frequencies (average 8.60±3.23) (p>0.05). Kupperman index values on initial, third and sixth months were 27.3±4.8; 10.2±2.9 ; 9.8±2.7 in pulsed estrogene-MPA group and 7.9±3.9 ; 10.5±2.3 ve 10.2±2.1 in conjugated estrogen-MPA group and no significant difference were found between the groups (p>0.05). The withdrawal bleeding was seen more frequently in oral conjugated estrogen-MPA group. But the difference was not significant (p=0.061). In the same way, the irregular bleeding (every bleeding pattern except withdrawal bleeding) episodes were seen in conjugated estrogen-MPA group more than the other group but, the difference was not significant (p=0.426). CONCLUSION: The efficacy and tolerability of pulse estrogene-MPA therapy in physiological postmenopausal patients was similar to oral conjugated estrogene-MPA therapy and could be used as an effective therapeutic choice.
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum
Kaynak
Jinekoloji ve Obstetrik Derg.
WoS Q Değeri
Scopus Q Değeri
Cilt
19
Sayı
2
