Effects of four different regimens of hormone replacement therapy on hemostatic parameters: A prospective randomized study
| Autor: | M. Anıl Onan, Türkiz Gürsel, Rifat Gursoy, Cagatay Taskiran, Ozdemir Himmetoglu, M. Zeki Taner, Erdem Karabulut, Erdinc Ozpolat |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Randomization medicine.drug_class medicine.medical_treatment Urology Administration Oral Medroxyprogesterone Acetate Administration Cutaneous Hysterectomy General Biochemistry Genetics and Molecular Biology Internal medicine Plasminogen Activator Inhibitor 1 medicine Humans Medroxyprogesterone acetate Prospective Studies Aged Transdermal Hemostasis Estrogens Conjugated (USP) Estradiol business.industry Estrogen Replacement Therapy Fibrinogen Obstetrics and Gynecology Hormone replacement therapy (menopause) Middle Aged Drug Combinations Norethindrone Acetate Treatment Outcome Endocrinology Estrogen Tissue Plasminogen Activator Toxicity Female Norethindrone business Plasminogen activator hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Maturitas. 53:267-273 |
| ISSN: | 0378-5122 |
| DOI: | 10.1016/j.maturitas.2005.05.010 |
| Popis: | Objective To compare the effects of four different regimens including oral and transdermal formulations with or without progestins on the hemostatic system in a prospective randomized fashion. Methods Eighty-eight women were randomized to four groups receiving continuous transdermal estradiol 50 μg/day (tE 2 ), oral conjugated equine estrogen 0.625 mg/day (CEE 0.625 mg), oral conjugated equine estrogen 0.625 mg/day plus medroxyprogesterone acetate 2.5 mg/day (CEE 0.625 mg/MPA 2.5 mg), or oral 2 mg 17-β estradiol combined with 1 mg norethistrone acetate (E 2 /norethistrone). The hysterectomized patients received only estrogen, and the remaining women received the estrogen plus progesterone combination regimens. As a marker of hemostatic system fibrinogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1) levels were measured initially, and after 1 and 6 months of therapy. Results The treatment groups were well matched for baseline characteristics including age, height, weight, body mass index, and systolic and diastolic blood pressures. During the study period fibrinogen levels were below the baseline values in all groups. However, the decrease was only statistically significant in patients treated with oral 0.625 mg/day CEE. tPA levels were decreased significantly by tE 2 , CEE 0.625 mg, and CEE 0.625 mg/MPA 2.5 mg. PAI-1 levels were decreased significantly by CEE 0.625 mg, and CEE 0.625 mg/MPA 2.5 mg. When the effects of the four different regimens were compared using percentage changes from the baseline, no significant difference was found among the treatment groups. Conclusion one of the treatment regimens resulted in a more coagulable state. Oral therapy with CEE decreased the levels of all parameters, and MPA did not impair this beneficial effect, except for in fibrinogen. Transdermal therapy had a minimal effect. No significant difference was noted among the four regimens. |
| Databáze: | OpenAIRE |
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