Effects of nomegestrol acetate administered alone or with cutaneous 17 beta estradiol in inversed sequence on cycle quality and hot flashes in periomenopausal women

According to the WHO definition perimenopause is the period preceding the definitive end of a woman s reproductive years during which clinical and/or biological signs signal the approach of menopause and at least the year which follows the last regular menstruations. The authors compared among perimenopausal women the effects upon the quality of their menstrual cycles hot flashes and the biological tolerance of nomegestrol acetate administered at the dose of 5 mg/day in an antigonadotropic sequence of 21 days on 28 alone or together with cutaneous 17beta-estradiol in inversed sequence at the dose of 1.5 mg/day 11 days on 21 during 6 cycles. This prospective study was conducted from April 1995 to December 1996 on two parallel groups with 36 women in each group who presented with diverse menstrual-related problems sometimes associated with hot flashes. Recruited in 19 French gynecology centers in the Lille region the 72 patients included in the study were at least 40 years old of the approximate mean age 45 years. 36 women without contraindications to estrogens received progestogen and estrogens while the other women received only progestogens. The quality of cycles hot flashes and general well-being were noticeably improved in both groups. Menstrual symptoms improved in 90% of cases while symptoms disappeared in 40-85% of cases depending upon the symptom. Hot flashes improved in 74% of cases with disappearance in 47% of cases.