RESUMO
OBJECTIVE: To investigate the long-term effects of a levonorgestrel-releasing intrauterine system on the endometrium and lipid profile of breast cancer patients taking tamoxifen. STUDY DESIGN: A total of 142 postmenopausal women taking tamoxifen were included in the study. A levonorgestrel-releasing intrauterine system was fitted to 70 women in the study group; a further 72 women acted as the control group. All women were followed for 36 months. Serum lipids were measured at the beginning and at the end of 36 months. Endometrial biopsies were obtained by hysteroscopy at the beginning and at the end of the 36th month in both groups. RESULTS: After 36 months, there were minor changes in serum lipids, fewer endometrial polyps and no endometrial hyperplasia in the study group compared to the control group. CONCLUSION: The levonorgestrel-releasing intrauterine system does not affect serum lipid levels significantly and may prevent the increased risk of endometrial polyps and hyperplasia associated with the use of tamoxifen in women with breast cancer. This may reduce the need for investigation of side-effects in women taking tamoxifen and also reduce patient discomfort while improving treatment adherence.
Assuntos
Antineoplásicos Hormonais/efeitos adversos , Anticoncepcionais Femininos/farmacologia , Endométrio/efeitos dos fármacos , Dispositivos Intrauterinos Medicados , Levanogestrel/farmacologia , Lipídeos/sangue , Tamoxifeno/efeitos adversos , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Interações Medicamentosas , Endométrio/patologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Cooperação do Paciente , Satisfação do Paciente , Pólipos/induzido quimicamente , Pólipos/patologia , Pós-Menopausa , Tamoxifeno/uso terapêutico , Resultado do Tratamento , Doenças Uterinas/induzido quimicamente , Doenças Uterinas/patologiaRESUMO
OBJECTIVE: To search and compare the effects of three different HRT regimens on nitric oxide levels of postmenopausal women. METHODS: Four groups of postmenopausal women were included in this prospective, randomised, placebo controlled study. 34 women used 0.625 mg conjugated estrogen continuously combined with 5 mg medroxyprogesterone acetate, 32 women used 2.5 mg tibolone, 26 women used 50 mcg transdermal estrogen alone continuously and 32 women used placebo for 12 months. Before the treatment and after 1 year, serum NO (nitrate/nitrite) and some other biochemical parameters were evaluated. RESULTS: All HRT using groups had increased serum nitric oxide levels significantly compared to placebo group and also there was not any difference among three HRT using groups concerning to increases in nitric oxide levels. CONCLUSION: Both conjugated estrogen combined with continuous progestin and transdermal estrogen alone and also tibolone increases serum nitric oxide levels of postmenopausal women equally for 12-months of treatment.
