Source: Chest  |  Posted 10 years ago

Dose size of trimegestone, not duration of treatment, is the key determinant of the bleeding pattern in post-menopausal women on this particular hormone replacement therapy.

This is the finding by May Wahab and colleagues from Leicester Royal Infirmary, Leicester, and King's College Hospital, London, England.

Trimegestone dose largely determines bleeding pattern in women on estradiol (E2) and sequential combined trimegestone administered in four doses, reported these authors earlier. In this current study, the team analysed the menstrual diaries of 134 post-menopausal women who, after a dose-ranging study of trimegestone, entered a six-month extension phase.

During the extension, all of the women received one dose of trimegestone (0.25 mg) in a sequential fashion (day 15 to 28) combined with continuous E2 (2 mg/day).

Women on trimegestone 0.25 mg/day during the first six months of the study experienced no change in bleeding pattern in the six-month extension. However, women on a dose of 0.5 mg/day experienced earlier onset and more prolonged bleeding following the change to 0.25 mg/day.

Women who previously received trimegestone doses of 0.05 mg and 0.1 mg experienced later onset, lighter and shorter-lived bleeding during the extension phase as compared with the first six months.

The issue is important because abnormal bleeding is a major reason for non-compliance with hormone replacement therapy.