Incidence of endometrial spotting or bleeding during continuous-combined estrogen-progestin therapy in postmenopausal women with and without hypertension. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Sriprasert, Intira; Beydoun, Hind; Barnabei, Vanessa; Nassir, Rami; LaCroix, Andrea Z.; Archer, David F.
• Is Part Of: Menopause. Volume 22:Issue 10(2015)
• Publication Date: 2015-10
• Subjects: Menopause -- Periodicals; 618.175005
• DOI: 10.1097/GME.0000000000000436
• Languages: English
• ISSNs: 1072-3714

Abstract

<abstract> <title>Abstract</title> <sec> <title>Objective:</title> <p>Endometrial spotting or bleeding is a common adverse effect among women taking continuous-combined estrogen-progestin therapy. The renin-angiotensin-aldosterone system plays a major role in hypertension and is present in the endometrium. We hypothesized that postmenopausal women with hypertension would have a higher incidence of bleeding compared with postmenopausal women without hypertension.</p> </sec> <sec> <title>Methods:</title> <p>A multivariate mixed-effects logistic model estimated the odds ratios for the relationship of hypertension status or use of antihypertensive drugs with endometrial bleeding using the Women's Health Initiative database.</p> </sec> <sec> <title>Results:</title> <p>The incidence of spotting or bleeding in the first 12 months of estrogen-progestin use was 42% in women aged 50 to 79 years. Women with hypertension were more likely to experience bleeding than women without hypertension (odds ratio, 1.07; 95% CI, 1.02-1.13). Overall antihypertensive medication use increased bleeding with an odds ratio of 1.24, whereas angiotensin II receptor antagonists had a reduced odds ratio (0.53).</p> </sec> <sec> <title>Conclusions:</title> <p>Postmenopausal women with hypertension are more likely to bleed than postmenopausal women without hypertension when taking continuous estrogen-progestin, with less bleeding in women using angiotensin II receptor antagonists. This finding is novel and supports our hypothesis that the endometrial renin-angiotensin-aldosterone system may contribute to endometrial bleeding.</p> </sec> </abstract>