Morphologic basis of hemorrhage during hormonal therapy in the climacteric syndrome

: In a group of 133 postmenopausal women in the course of nine years the relationship between two types of hormonal treatment and one of the side-effects--metrorrhagia--was investigated. This symptom was found in 37 patients. The authors followed two aims. To evaluate the relationship between treatment of the climacteric syndrome and the morphological state of the uterine mucosa and to assess the optimal therapeutic pattern under local conditions. The insignificant frequency of proliferating endometrial changes supports some data in the literature which draw attention also to other causes of haemorrhage. With regard to therapeutic regimes, the authors consider continual administration of conjugated oestrogens--0.625 mg and medroxyprogesterone acetate 5 mg per day as suitable. They emphasize the necessity to follow up the patients in a special clinic with the opportunity to make hormonal examinations and to ensure interdisciplinary collaboration.