Comparison of megestrol acetate and clomiphene citrate as supplemental medication in postmenopausal oestrogen replacement therapy

@article{Kauppila2005ComparisonOM,
  title={Comparison of megestrol acetate and clomiphene citrate as supplemental medication in postmenopausal oestrogen replacement therapy},
  author={A. J. I. Kauppila and Seppo Kivinen and Pekka J Leinonen and Risto Tuimala and Reijo K. Vihko and Pekka Yl{\"o}stalo},
  journal={Archives of gynecology},
  year={2005},
  volume={234},
  pages={49-58}
}
SummaryIn a prospective clinical trial lasting one year, 35 postmenopausal women with severe climacteric symptoms were cyclically treated with conjugated oestrogens (1.25 mg daily). This oestrogen replacement therapy was randomly supplemented with 10 mg of megestrol acetate daily (18 women) or 50 mg of clomiphene citrate (17 women) for 10 days four times a year. Both treatment regimens significantly alleviated climacteric symptoms. At the end of the oestrogen-megestrol acetate treatment no… 
1 Citations
Tissue selective estrogen complex (TSEC): a review
TLDR
Choice of SERM, selection of doses, and clinical trial data evaluating safety and efficacy are key to ensuring safety and adequate therapeutic effect of TSECs for addressing menopausal symptoms.

References

SHOWING 1-10 OF 32 REFERENCES
Cyclic clomiphene citrate treatment lowers cytosol estrogen and progestin receptor concentrations in the endometrium of postmenopausal women on estrogen replacement therapy.
TLDR
Because the effect of clomiphene citrate was independent of simultaneous estrogen administration, it acted as a pure antiestrogen in this treatment modality and the relative decreases in estrogen and progestin receptor concentrations on the present treatment regimen were different from those previously found on progestsin treatment.
Postmenopausal hormone replacement therapy with estrogen periodically supplemented with antiestrogen.
Progestin therapy in advanced breast cancer: Megestrol acetate—an evaluation of 160 treated cases
TLDR
Megesterol acetate therapy may be the first choice of treatment in late postmenopausal patients with soft tissue and lung metastases and no great differences in remission rates were found between patients treated with megestrol acetate as the first hormonal treatment and those previously treated with hormones.
Effects of estrogens and progestins on the biochemistry and morphology of the postmenopausal endometrium.
TLDR
It is concluded that many estrogen preparations subject the endometrium to a potent stimulus, and norethindrone and norgestrel are protective because they counteract the proliferative effects of estrogens, but the currently recommended daily dosages of these progestins can be greatly reduced without loss of response.
Relations between bleeding pattern, endometrial histology, and oestrogen treatment in menopausal women
TLDR
The risk of developing endometrial carcinoma from oestrogen treatment may be reduced by avoiding the use of unopposed ostrogen regimens, the addition of more than five days' treatment with a progestogen, and recognising that a regular bleeding response to oestrogens is no guarantee of a healthy endometrium.
Prevention and treatment of endometrial disease in climacteric women receiving oestrogen therapy.
TLDR
The treatment regimens are described in 74 patients with endometrial disease among 850 climacteric women receiving oestrogen therapy and demonstrated the problems of inappropriate and unsupervised unopposed oestrogens therapy and the difficulty in distinguishing severe hyperplasia from malignancy.
A PROSPECTIVE, CONTROLLED TRIAL OF SIX FORMS OF HORMONE REPLACEMENT THERAPY GIVEN TO POSTMENOPAUSAL WOMEN
TLDR
From the data the following broad conclusions can be drawn: some women have classic symptoms of hot flushes and sweating despite high endogenous oestrogen concentrations; vaginal cytology is a relatively poor indicator of endogenous Oestrogen status; and most women experience significant or complete relief of symptoms on all forms of HRT as do some women taking a placebo.
...
1
2
3
4
...