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Human Reproduction, Vol. 11, No. suppl_2, pp. 115-123, 1996
© 1996 European Society of Human Reproduction and Embryology

The effect of transdermal oestradiol on bleeding pattern, hormonal profiles and sex steroid receptor distribution in the endometrium of Norplant users

Wisut Boonkasemsanti1, Damrong Reinprayoon1, Kamthorn Pruksananonda1, Somchai Niruttisard1, Surang Triratanachat1, Smai Leepipatpaiboon1 and Pongsak Wannakrairot2

1 Departments of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkom University Rama IV Road, Bangkok 10330, Thailand 2 Departments of Pathology, Faculty of Medicine, Chulalongkom University Rama IV Road, Bangkok 10330, Thailand

The most common side-effect and reason for discontinuation with Norplant use is bleeding disturbance. The aim of this study was to investigate whether the 6 week application of a patch which released 100 µg/day oestradiol would reduce the number of abnormal bleeding days or eliminate the problem. Another objective was to find out the correlation between the bleeding pattern and endometrial concentrations of oestrogen receptor (ER) and progesterone receptor (PR). Of 98 Norplant users, 34 patients had normal bleeding patterns and 64 patients had abnormal bleeding patterns. An oestradiol patch or a placebo patch were randomly used to treat 33 and 31 women with abnormal bleeding respectively. There was a clinical improvement in the oestradiol group compared with the placebo group, although this was not statistically significant There were no correlations between PR and ER concentration and the serum oestradiol, progesterone, levonorgestrel and sex hormone-binding globulin concentrations. Significantly increased mean immunostaining scores of stromal PR were observed in those Norplant users whose endometrium had an atrophic histological appearance. The serum oestradiol concentration did not show a significant change after treatment with the oestradiol patch compared with the placebo patch.

Key words: endometrium/immunohistochemistry/Norplant/steroid receptors/transdermal oestradiol


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