A small study presented at the 2014 ACOG Annual Clinical Meeting suggests that a selective estrogen receptor modulator (SERM) plus estrogen may have promise in treatment of perimenopausal symptoms. According to Japanese researchers, the combination—known as tissue-selective estrogen complex—improved climacteric symptoms and bone resorption markers without severe side effects.
Patients enrolled in the study, by investigators from Hamada Hospital, Tokyo, were 221 perimenopausal women aged 52.6±2.5 years with menopausal symptoms who wanted to take hormonal therapy. They were treated with 0.625 mg conjugated estrogen plus 20 mg bazedoxifene daily for a year. Assessments before and during therapy included transvaginal ultrasound for endometrial thickness, plasma estradiol, type I collagen cross-lined N-telopeptide (NTx) levels, and changes in hot flushes based on a 0 to 3 scale, with 0 being no flushes, 1 mild, 2 moderate, and 3 severe flushes.
No significant changes were seen in endometrial thickness or plasma estradiol levels nor did the investigators note severe side effects in the women. Significant improvement was seen, however, in hot flushes (from 2.8±0.3 to 0.3±0.2, P
<.01). Plasma NTx levels also were decreased by the tissue-selective estrogen complex therapy (from 23.0±12.3 to 6.1±4.7 nmol BCE/L, P
Tsuchiya F, Aisaka K, Ikezuki Y, et al. New strategy for hormone therapy using estrogen combined with a selective estrogen receptor modulator. Obstet Gynecol
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