Abdullah TOK, Gülcan AKDEMİR, Alev ÖZER, Gürkan KIRAN

Disfonksiyonel uterin kanamanın tedavisinde mikronize vajinal progesteron ile oral didrogestronun karşılaştırılması: etkinlikleri ve lipid profili üzerindeki etkileri

Amaç: Bu çalışmanın amacı, kısa süreli oral didrogesteron ile vajinal mikronize progesteronun etkinliğini karşılaştırmayı ve disfonksiyonel uterin kanamalı premenopozal kadınlarda lipid profili üzerindeki etkilerini belirlemeyi amaçlamaktadır. Gereç ve Yöntem: Disfonksiyonel uterin kanaması olan toplam 70 premenopozal kadın, çalışmaya dahil edildi. 35 hastaya (Grup 1) 90 mg vajinal mikronize progesteron (% 8 jel), diğer 35 hastaya20 mg oral didrogesteron (Grup 2) almak üzere rastgele atandı. Grup 1 tedavisi, adet döngüsünün 17. ila 27. günü arasında her akşam üç döngü boyunca kendi kendine vajinal progesteron uygulamasından oluşuyordu. Grup 2'deki hastalar menstrüel siklusun 15. gününden başlayarak 10 gün süreyle günde iki kez 10 mg oral didrogesteron ile üç döngü boyunca tedavi edildi. Bulgular: Üç kür vajinal progesteron tedavisinden sonra vücut kitle indeksi anlamlı olarak artarken, oral didrogesteron tedavisi sonrası vücut kitle indeksi ve serum LDL konsantrasyonu anlamlı olarak arttı. Her iki grupta da tedavinin tamamlanmasından sonra sekretuar endometriumlu hasta sayısı anlamlı olarak arttı. Sonuç: Mikronize progesteronun vajinal uygulaması, disfonksiyonel uterin kanamasının tedavisinde oral progestinlere bir alternatif olabilir. Vajinal mikronize progesteron tedavisi oral progestin tedavisi kadar etkili görünmektedir ve aynı zamanda kolay uygulama avantajına sahip olduğu ve lipid profili üzerinde hiçbir yan etkisi olmadığı görülmektedir.

Anahtar Kelimeler:

Dysfunctional uterine bleeding, oral dydrogesterone, vaginal progesterone

Micronised vaginal progesterone versus oral dydrogestrone in the treatment of dysfunctional uterine bleeding: efficacy and effects on lipid profile

Purpose: The aim of this study was to compare the efficacy of short-course oral dydrogesterone versus vaginal micronized progesterone and to determine their effects on the lipid profile of the premenopausal women with dysfunctional uterine bleeding. Materials and Methods: A total of 70 premenopausal women with dysfunctional uterine bleeding were randomly assigned to receive 90 mg of vaginal micronized progesterone (8% gel) (Group 1, n = 35) or 20 mg of oral dydrogesterone (Group 2, n = 35). The group 1 treatment consisted of self-application of vaginal progesterone, every other evening from the 17th to the 27th day of the menstrual cycle, for three cycles. The patients in Group 2 were treated with dydrogesterone 10 mg orally twice daily for 10 days, starting from the 15th day of the menstrual cycle, for three cycles. Results: Body mass index increased significantly after three cycles of vaginal progesterone treatment whereas body mass index and serum LDL concentration increased significantly after three cycles of oral dydrogesterone treatment. The number of patients with secretory endometrium increased significantly after the completion of treatment in both groups. Conclusion: Vaginal administration of micronized progesterone may be an alternative to oral progestins in the treatment of dysfunctional uterine bleeding. Vaginal micronized progesterone treatment seems to be as effective as oral progestin treatment and it also appears to have the advantage of easy application and no adverse effects on the lipid profile.

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