Continuous intrauterine compared with cyclic oral progestin administration in perimenopausal HRT.

OBJECTIVES: Two hormone replacement therapy (HRT) regimens of combined oral estradiol with either continuous intrauterine or cyclic oral progestin were compared for 2 years. METHODS: 200 perimenopausal women randomly received an intrauterine system with continuous levonorgestrel release (20 microg/24 h) combined with oral estradiol (2 mg daily), or a cyclic oral regimen of norethisterone acetate (1 mg on day 13-22) and estradiol (days 1-21; 2 mg, days 22-28; 1 mg). Efficacy on endometrial protection, vaginal bleeding patterns, blood loss and practical use were compared during 26 cycles. RESULTS: Endometrial protection was adequate in both regimens. The cyclic regimen induced a more regular bleeding pattern. The continuous local administration induced a reduction in bleeding (P=0.001) with an initial period of prolonged and frequent bleeding. 38% became amenorrhoeic. Women found both regimens acceptable. CONCLUSIONS: Continuous intrauterine Levonorgestrel administration by using an intrauterine system can well be recommended for use in combination with oestrogen replacement therapy in perimenopausal women.

Characteristics and treatment of patients with chronic eating disorders.

This article presents the results of a study of 41 patients with an eating disorder (ED) for ten years or longer. Their mean age was 34 years, the mean duration of their ED was 15.2 years, and their mean lowest BMI was 14.8. We describe the characteristics of their ED, weight history and BMI, the reasons for the onset of their ED, the physical and psychological complaints and social problems, the process of diagnosing their ED, the treatment history, and the patients' evaluation of their treatments. Finally, we will describe whether the patient recovered. The article ends with a discussion about possibly improving their treatment and quality of life.