[Substitution estrogen therapy in the prevention of postmenopausal osteoporosis and cardiovascular diseases. Results of long-term therapy]. / La estrogeno-terapia sostitutiva nella prevenzione dell'osteoporosi e della patologia cardiovascolare in postmenopausa. Risultati del trattamento a lungo termine.

In the present report, the current approach to the prevention of metabolic damage deriving from oestrogen deficiency involves the use of protocols that vary in the type of hormone employed and the mode of its administration. A homogenous group of 28 postmenopausal women was treated with natural conjugates oestrogen (0.625 mg per diem per os) on a continuous basis plus MAP (10 mg per diem per os) for 12 days a month. The metabolic effect of the oestrogen replacement therapy was assessed annually by blood chemical screening of the lipid situation and the phosphocalcium balance. Computerised radial bone mineralometry using SPA technique was also performed. A smaller group of 19 court of the 28 patients was also subjected to transversal assessment of vertebral BMD using the DXA technique. The results in this latter group were compared with those in 19 women not given oestrogen treatment who had been postmenopausal from 5-7 years. Results after 60 months of treatment confirm the efficacy of oestrogen therapy in preventing the deterioration of the lipid profile and the loss of bone mass after menopause.

Diagnostic outpatient aspiration curettage. Two years experience.

Endometrial aspiration curettage was performed on 1001 women, without anaesthesia. Our experience confirms that Vabra-curettage is, for patients, a simple and well tolerated sampling technic. We were not able to perform the technic in 18 patients for close cervical stenosis. In 41 patients the samples were quantitatively not adequate for a correct histological diagnosis. In all these cases a control by D & C was performed, in general anaesthesia, and no proliferative pathology was found. The most common presenting symptom in Intraepithelial Carcinoma of Endometrium (ICE) and in carcinoma was abnormal vaginal bleeding; nevertheless 5 cases of ICE and 2 cases of adenocarcinoma did not show any symptom. This study confirms that systematic screening of asymptomatic perimenopausal and postmenopausal women may lead to the discovery of occult endometrial cancers, some of which are advanced.