Endocrine Abstracts (2006) 11 P661

Hormone replacement therapy in postmenopausis fails to normalize gonadotropins – does it matter?

J Zmire, P Cvitkovic, P Jukic, B Colak, D Lucinger, L Sokolic, B Rocic & K Kljajic

Vuk Vrhovac, University Clinic, Zagreb, Croatia.

Level of pituitary trophic hormone dictates dose of hormone replacement (HRT) in endocrine gland hypofunction. We examined 28 women receiving HRT in postmenopausis aged 46–63 yrs (54±4.27 yrs). In average patients started HRT two years after last spontaneous menstrual bleeding (28±3.76 months, 1–132 months). 8 patients used transdermal estradiol, 10 peroral combination of estradiol, estriol and norethisterone and 10 patients were treated by fixed peroral combination of estradiol and norethisterone. Average duration of treatment was 24±17.96 (3–72) months.Hormones were determined by commercial kits. Folicle stimulating hormone (FSH) and luteizing hormone (LH) values were 39.42±22.74 (4.3–83) U/l (Normal values: 2.4–9.3– follicular phase) and 24.43±14.41(2–53) U/l (Normal values: 1.6–9.3) respectively. At the same time estradiol level was 0.21±0.12 (0.05-0.44) nmol/l (Normal values for follicular phase: 0.08–0.79) and progesterone ranged from 0.26–1.9 (0.87±0.37) nmol/l (Normal values for follicular phase: 0.6–3.6). FSH was normal in only one patient receiving fixed combination of estradiol and norethisterone, LH was normal in six patients. All patients were free of menopausal symptoms and side effects of HRT. Results show lack of normalization of gonadotropins despite normal values of estradiol. And yet this way of treatment is considered satisfactory in terms of achieving main targets of HRT in postmenopausis: relieving menopausal symptoms, prevention of osteoporosis, protection of cardiovascular system and eventualy central nervous system. Authors wonder if different approach in dosing would improve any outcome of HRT.

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