Impact of Various Treatment Regime on Lipid Profile and Clinical Parameters
F.Fischl*
Affiliation : * Department of Gynecological Endocrinology and Reproductive .'vledicme. Lnivcrsity of Vienna, Wahringer Gtirtel 18-20, A-1090 Vienna, Austria
The western world and thus also Europe do not so much have a problem of population
explosion as one of age explosion.
The average life expectancy of women is 80 years.
whereas the average menopausal age is 51 to 52 years.
Life expectancy has thus doubled in
150 years, but the age of menopause has only risen slightly.
The long hormone-free period.
hut also the distinct advantages of hormone replacement therapy (HRT). which has only a few
contraindications and side effects has made HRT highly valuable in prophylactic medicine
and there are many ways of applying HRT (2). The same changes will happen in a few years
in Thailand and also in whole Asia.
With a higher living standard. live expectancy will nse
and the hormone free period too.
The Thai women life expectancy is now 6Y. 75 years and
the average age of menopause 49.5 years.
Cyclo-Progynova (II tab!. with 2.0 mg estradiol valerate and 10 tab! with 2 mg
estradiol valerate + 0.5 mg norgestrel ).
Progynova (21 table with I or 2 mg estradiol valerate)
and Climen (II tab! with 2 mg estradiol valerate and 10 tab! 2 mg estradiol valerate + l mg CPA).
novels oral hormones for replacement therapy, have been used now for many years in Austria
and other European countries.
They are well tolerated with only little side effects.
All three
medicaments contain the most potent human estrogen. 17f3 estradiol. as the esterified prodrug
estradiol valerate, 2 mg or I mg/day for the entire cyclic therapy of 21 days (I). The progestogen
norgestrel at 0.5 mg and the cyproterone acetate (CPA) at I mg is added during days 12 to 21.
No therapy is administered during the fourth week of the cycle.
During this time a menstrua-
tion like bleeding is expected.
Cyclo-Progynova and Climen as fixed combinations of estrogen and progestogen,
effectively treat climacteric complaints while preventing endometrial hyperplasia and providing
endometrial protection subsequently.
Early studies showed that administration of exogenous
estrogen alone leads to a significant increase in the risk of developing endometrial cancer in non
hysterectomized women.
However it is now well established that the risk of endometrial
hyperplasia, thought to be a precursor of endometrial cancer. can be reduced by addition of a
progestogen.
The incidence of hyperplasia seems to decrease when progestogen therapy is
administered for at least 10 days a month.
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