口服和经皮雌激素替代疗法对手术绝经妇女围绝经症状、血脂和凝血功能的影响

目的:研究口服和经皮雌激素替代疗法(ERT)对手术绝经妇女围绝经症状、血脂和凝血功能的影响。方法:手术绝经妇女随机分为口服组和皮贴组,分别使用雌二醇(E2)口服片(1 mg/d)和雌二醇皮贴片(1.5 mg/周)3个月。用药前、后分别检测血中E2和卵泡刺激素(FSH)水平,评估围绝经症状和生存质量,测定血脂和凝血功能。结果:口服组和皮贴组用药后血清E2水平明显升高,FSH水平明显降低,围绝经症状和生存质量均得到明显改善,组间无统计学差异。口服组用药后三酰甘油(TG)、高密度脂蛋白(HDL)较治疗前显著上升,低密度脂蛋白(LDL)较治疗前显著降低;皮贴组用药后HDL较治疗前有升高趋势,但差异无统计学意义(P>0.05),LDL较治疗前显著降低(P<0.05)。口服组用药后活化部分凝血活酶时间(APTT)较治疗前显著降低,其余各凝血指标与治疗前比较均无统计学差异;皮贴组用药后各凝血指标均较治疗前无显著变化。结论:口服和经皮ERT均能改善手术绝经妇女的围绝经症状,但两者在血脂和凝血方面作用不同。     

激素替代治疗中应用左旋18甲基炔诺酮宫内释放系统的3年随诊

45例年龄44～66岁因绝经症状要求治疗的围绝经期和绝经后妇女,在采用经皮雌二醇贴剂、皮下埋植或口服雌二醇连续替代的同时,宫腔内置入每     

口服、经皮激素替代治疗对NO、ET-1、前列环素、TMXA_2的长期影响

作者对63例年龄<60岁,绝经≥6个月,血浆FSH>30IU/L,E_2<36.4pg/ml,子宫完好,身体健康,有更年期症状采用激素替代治疗(HRT)的妇女进行了研究。随机分为口服及经皮用药两组。口服组31例,于治疗周期第1～12天每晚口服雌二醇(E_2)2mg,第13～22天E_2 2mg并加服醋酸炔诺酮1mg,第23～28天E_2改为1mg。经皮组32例,周期第1～13天单用E_2 50μg/d,第14～28天E_2 50μg/d并加用醋酸炔诺酮250μg/d。于治疗前及治疗后第     

激素替代治疗对绝经后妇女血清脂蛋白(a)的影响

目的 探讨戊酸雌二醇和倍美力对心血管疾病独立危险因子脂蛋白(a)[Lp(a)]的影响。方法 60例绝经后病例,按1:1随机分成两组,行连续序贯方案治疗,其中倍美力组30例口服结合雌激素0.625mg/d加醋酸甲孕酮4mg/d;戊酸雌二醇组30例口服戊酸雌二醇1mg/d加醋酸甲孕酮4mg/d。两组均连续治疗16周,于用药前、用药9周、16周取血测定血Lp(a),同时测血雌二醇水平。结果 两组用药后9周和16周Lp(a)均显著下降(P<0.01);两组间用药各时相Lp(a)水平差异无显著性(P>0.05)。两组用药前后E_2水平均显著升高(P<0.01),达正常月经周期早卵泡期水平。结论 激素替代治疗可使心血管疾病独立危险因子Lp(a)降低。     

口服及经皮肤给17β-雌二醇对绝经后妇女的生物学影响

绝经后妇女使用雌激素替代治疗(ERT)可缓解绝经期症状,防止骨质疏松。但应注意减少肝代谢改变及由此引起的高血压、高血脂症、动静脉血栓栓塞性疾病及心血管疾患等并发症。对给药途径或雌激素剂型、剂量对防止并发症何者更为重要,各家意见不一。本文通过口服及经皮肤给17β-雌二醇(E_2)前后观察肝及血液各项生物及生化指标的变化,探讨ERT不同给药途径的利弊。受试者分两组:(1)口服组口服粉末化E_2(E_2     

子宫内膜异位症根治术后激素替代治疗疗效观察

目的　探讨激素替代治疗Ⅲ～Ⅳ期子宫内膜异位症根治术后 (全子宫及双侧附件切除术后 )的临床疗效与安全性。方法　 2 0 0 1年 3月至 2 0 0 2年 12月将 30例患者随机分成两组 (各 15例 ) :观察组口服戊酸雌二醇0 5～ 1 0mg ,每日 1次。对照组口服利维爱 1 2 5mg ,每日或隔日 1次。治疗前后检查盆腔情况、肝肾功能、体内血清FSH(卵泡刺激素 )、血清E2 (雌二醇 )水平 ,记录治疗期间盆腔痛、性交痛等子宫内膜异位症相关症状和乳房胀痛等不良反应 ,Kupperman评分 (K评分 )每月 1次。 结果　两组用药后围绝经期症状均明显改善 ,无子宫内膜异位症复发表现 ,血浆E2 水平上升 ,治疗前后比较差异有显著性意义 (P <0 0 1)。治疗后E2 水平观察组高于对照组 ,两组比较差异有显著性意义 (P <0 0 1) ,但均在安全范围内。结论　小剂量戊酸雌二醇和利维爱用于Ⅲ～Ⅳ期子宫内膜异位症根治术后患者 ,均能安全、有效地控制围绝经期症状。     

激素治疗对绝经妇女子宫肌瘤的影响

目的:观察个体化周期序贯激素治疗对绝经妇女子宫肌瘤发生及生长的影响。方法:选择因绝经相关症状且合并单发性子宫肌瘤(肌瘤最大径线<5 cm)的绝经妇女60例,给予雌孕激素周期序贯方案,起始剂量为口服戊酸雌二醇1.0 mg,每日1次,连用21~25天,后10~14天加用甲羟孕酮每日4 mg。随后,根据每人对药物的不同反应,调整口服戊酸雌二醇的每日用量为0.5~2.0 mg,甲羟孕酮的每日用量相应为4~6 mg。不能连续应用激素治疗或失访者被排除。分别于治疗前及治疗3、6、122、43、6个月时采用阴道超声测定肌瘤大小及子宫内膜厚度。结果:53例患者完成了3年的观察,平均年龄51.4(44~57)岁,绝经年限平均2.3(1~7)年。激素周期序贯治疗3、6、12、24、36个月,肌瘤大小均无明显改变(P>0.05),没发现新生肌瘤(P>0.05),子宫内膜厚度均无明显增厚(P>0.05)。结论:根据个体对药物反应不同制定不同剂量的激素周期序贯方案,不促进绝经妇女子宫肌瘤的发生和生长。     

绝经后妇女雌二醇的半衰期

为确定绝经后妇女使用经皮吸收雌二醇(E_2)的半衰期和代谢,前瞻性研究8例绝经后健康妇女。受试者不吸烟,未使用任何药物。符合以下标准:体检正常,1年内行乳房X照像,停经1年以上,FSH>40mIU/ml,红细胞压积>0.36(36%),BUN、肌酐、转氨酶正常,体重指数(BMI)<28。经皮吸收E_2贴剂(E_2 0.01mg)贴于受试者腹壁。13小时后,经晚间禁食取去E_2贴剂。在使用E_2贴剂前,取去E_2贴剂前30分钟、及取去E_2贴剂后6小时采血。取血清测定E_2,雌酮(E_1)及硫酸雌酮(E_1S)水平。     

雌二醇皮肤擦剂伴同微粒孕酮口服对阻绝经期凝血机制的作用

妇女应用合成雌、孕激素制剂有发生血栓、栓塞危险、主要由于凝血机制改变,呈现高凝状态。在围绝经期如已伴有心血管危险因素,则避免高凝状态的出现更为重要。作者对33例围绝经期妇女,年龄44～55岁,无心血管病史,3个月内未应用激素,因更年期症状群就诊者进行研究。对其中28例已证实绝经者,隔日经皮肤给雕二醇凝胶(Oestrogel),每月20天。再于第十至二十天,每日口服微粒孕酮200～300mg。每月停药10天。另对5例绝经前患者,自年经周期第十至二十五天,每月只口服微粒孕酮200～300mg,以纠正黄体功能不足。     

绝经后妇女舌下含服17β-雌二醇后血浆中雌二醇、雌酮、FSH和LH浓度及尿中雌二醇与雌酮总浓度的变化

合成的雌激素对改善绝经期症状虽然有效,但因对肝脏和心血管系统有副作用,目前已很少使用.现认为更适用的还是天然雌激素17β-雌二醇(E_2).作者研究了8例绝经后妇女舌下一次含服0.5mg E_2后,血浆中E_2,雌酮(E_1),FSH和LH浓度及尿中E_2 E_1总浓度的变化,并与经皮下注入E_2后的各激素浓度变化相比较,目的是为了探讨E_2能否经舌下被吸收.8例研究对象的年龄为47～69岁.其中6例为自然绝经,2例为双侧卵巢与子宫切除后绝经.绝     

The effects of progestins on bone density and bone metabolism in postmenopausal women: a randomized controlled trial

OBJECTIVE: The purpose of this study was to evaluate the action of progestins on bone metabolism in early menopausal women. STUDY DESIGN: One hundred thirty-two menopausal women were randomized into a 2-year double-blinded, placebo-controlled clinical trial. There were 6 treatment groups: micronized progesterone (P 4 ) 300 mg/day; medroxyprogesterone acetate (MPA) 10 mg/day; norethindrone (NET) 1 mg/day; micronized estradiol (E 2 ) 1 mg/day; E 2 1 mg/day + MPA 10 mg/day; and placebo. All subjects received 1000 mg of calcium and 400 IU of vitamin D/day. Primary outcome variables were bone mineral density (BMD) changes at the spine and hip. Secondary variables were bone turnover markers. RESULTS: With E 2 or E 2 +MPA treatment, BMD at L2-L4 increased by 2% to 4% over 2 years. Bone mineral density (BMD) at the spine followed a decreasing trend with MPA, P 4 , and placebo treatments. With NET treatment, BMD did not change from baseline. At the femoral neck site, BMD did not change significantly for any treatment group. Bone resorption and bone formation markers decreased with E 2 or E 2 +MPA treatment, and did not change appreciably with all 3 progestin-alone treatments. There were no vertebral or hip fractures observed during the trial. CONCLUSION: Estrogen remains the primary bone active agent in hormone therapy, while progestins have significantly less activity. The selection of the appropriate progestin in hormone therapy should be based on criteria other than bone activity.     

Action of low-dose estrogen and progestogen on the relief of climacteric symptoms and excretion of urinary calcium

The effects of low-dose estrogen and progestogen on menopausal symptoms and urinary excretion of calcium were studied with Kuppermen score and fasting morning urine Calcium/Creatinine (Ca/Cr) ratio, respectively, in 69 perimenopausal women. The women were divided into 3 groups: amenorrhea less than 1 year (14 women); post menopause 1 approximately 3 years (19); and post menopause more than 3 years (36). Fasting urine Ca/Cr ratio in the postmenopausal group 1 approximately 3 years was 0.19 +/- 0.01, significantly higher than that (0.14 +/- 0.01) in the amenorrhea group less than 1 year and (0.11 +/- 0.006) the postmenopausal group more than 3 years. 18 women received sequentially 4 patterns of low-dose oral estrogen and progestogen: MPA 2 mg Q O D., EE 5 micrograms Q D, EE 5 micrograms Q O D, and EE 5 micrograms and MPA 2 mg Q O D alternately. Each pattern was used for 3 weeks and discontinued for an interval of two 2 weeks, then started the next pattern and so on EE 5 micrograms and MPA 2 mg Q O D alternately gave the best results both in improving symptoms and lowering urine Ca/Cr ratio. Seven women having intermittent large dose EE 50 micrograms every 10 days or Premarin 2.5 mg every 7 days had symptoms relieved but inconsistent decrease of urine Ca/Cr ratio.     

绝经后妇女激素补充治疗后同型半胱氨酸及超声心动图改变的初步观察

目的　观察绝经后妇女激素补充治疗 (HRT)后血浆总同型半胱氨酸 [H(e) ]及超声心动图的改变。方法　将受试者分为 4组。Ⅰ组、Ⅱ组为自然绝经妇女 ,各 30例 ,其中Ⅰ组给予HRT(结合雌激素 0 6 2 5mg d ,安宫黄体酮 2mg d ,或者每月后 14d加安宫黄体酮 4mg d) 3个月 ;Ⅱ组不给予HRT ,为对照 ;Ⅲ组 2 0例 ,为已接受HRT1 5年的绝经后妇女 ;Ⅳ组 2 0例 ,为从未应用HRT的绝经后妇女。Ⅰ组、Ⅱ组受试者于接受HRT前及接受HRT 3个月后测定H(e) ;Ⅲ组、Ⅳ组受试者测定H(e) ,并行超声心动图检查。结果　Ⅰ组、Ⅱ组接受HRT 3个月前后H(e)无明显变化 ,Ⅰ组接受HRT前为(9 3± 2 5 ) μmol L ,Ⅱ组为 (9 4± 2 9) μmol L ;Ⅰ组接受HRT后H(e)为 (9 1± 2 8) μmol L ,Ⅱ组为(9 8± 3 6 ) μmol L。两组比较 ,差异无显著性 (P >0 0 5 )。Ⅲ组H(e)明显低于Ⅳ组 ,分别为 (8 0±1 3) μmol L及 (10 3± 3 2 ) μmol L。两组比较 ,差异有显著性 (P <0 0 5 )。Ⅲ组、Ⅳ组的超声心动图检查结果无明显改变。结论　短期应用HRT对H(e)无明显改善 ,长期应用HRT可降低H(e)水平。绝经后妇女应用HRT 1 5年 ,未见超声心动图有明显变化。     

Hormone substitution therapy. Side-effects and compliance of various therapeutic regimens]

BACKGROUND: The aim of this study is to evaluate the tolerability and long-term compliance of four Estrogen Progestin treatments (HRT) for menopause. METHODS: One hundred and ten symptomatic menopausal women were divided into four groups according to therapeutic regimens: A) Estradiol (E2) transdermal treatment 50 micrograms (TTS 50) continuously administered (cont.) plus Medroxyprogesterone Acetate (MPA) 10 mg/die for twelve days a month: 35 women. B) Conjugated Equine Estrogens (CEE) 0.625 mg/die cont. plus MPA for twelve days a month: 25 women. C) Estradiol transdermal 50 micrograms (cont.) plus MPA 2.5 mg/die cont.: 26 women. D) CEE 0.625 mg/die cont. plus MPA 2.5 mg/die cont.: 24 women. RESULTS: Menopausal symptoms were significantly reduced with all treatments. During the first year group C and D patients showed irregular bleeding (group C: 46%, group D: 61%). After 24 months the bleeding frequency was reduced (group C: 11%, group D: 13%). Mastodynia was the more frequent side-effect in particular among women who were utilizing cont.comb. regimens. The total percentage of drop out (D.O.) after 2 years was more than 30% (Group A: 31%, Group B: 33%, Group C: 39%, Group D: 35%). The most frequent reasons for abandoning HRT (79% of all DO) were not linked to therapy side-effects. 19% of DO switched to other hormonal regimens.     

Different cerebrovascular effects of medroxyprogesterone acetate and norethisterone acetate in the New Zealand White rabbit.

OBJECTIVE: The lack of a cardioprotective effect of hormone replacement therapy (HRT), as suggested by the Heart and Estrogen/progestin Replacement Study (HERS) and Women's Health Initiative (WHI) may in part be explained by the progestin used. The aim of this study was to elucidate the effect of different progestins on cerebrovascular reactivity in an animal model. METHODS: Fifty-six ovariectomized New Zealand White rabbits were randomized into seven groups receiving hormone treatment for 4 weeks: medroxyprogesterone acetate (MPA) (10 mg/day); norethisterone acetate (NETA) (3 mg/day); conjugated equine estrogens (CEE) (1.25 mg/day); 17beta-estradiol (E2) (4 mg/day); MPA + CEE (10 mg/day + 1.25 mg/day); NETA + E2 (3 mg/day + 4 mg/day); or placebo. Segments from the basilar and posterior cerebral arteries were mounted in myographs for tension recordings. Concentration-response curves to potassium, acetylcholine, sodium nitroprusside, L-NAME (N(omega)-nitro-L-arginine methyl ester), calcium and endothelin-1 were established. RESULTS: Treatment with MPA caused a significant increase in vasoconstriction, expressed as E(max) (mN/mm, mean +/- SEM; p < 0.05), in response to potassium (3.18 +/- 0.19 vs. 2.47 +/- 0.19) and calcium (4.00 +/- 0.22 vs. 3.34 +/- 0.14) in the posterior cerebral artery, and to endothelin-1 (6.88 +/- 0.69 vs. 5.22 +/- 0.30) in the basilar artery, when compared with NETA. This difference was neutralized in the groups receiving the combined treatment of MPA + CEE and NETA + E2. No overall differences were seen between CEE and E2. CONCLUSIONS: In rabbit cerebral arteries, MPA treatment causes a higher development in arterial tension compared with NETA, indicating that different progestins may display different cerebrovascular effects. However, when accompanied by estrogens, as in the case of HRT, this difference is eliminated.     

A randomized study of the effects of tibolone and transdermal estrogen replacement therapy in postmenopausal women with uterine myomas

OBJECTIVE: To evaluate the effects of two types of hormone replacement therapy, an estrogen-progestin combination and tibolone, on uterine myomas in menopausal women. STUDY DESIGN: Thirty-eight menopausal women with one or more uterine myomas were randomized to treatment with a transdermal system continuously releasing estradiol 50 microg/day combined with oral medroxyprogesterone acetate (MPA) 10 mg/day for 12 days/month or tibolone tablets 2.5 mg/day. The scheduled duration of both treatments was 12 months. Physical examination and abdominal/transvaginal ultrasonography were performed before entering the study and at 3, 6 and 12 months of treatment. At each ultrasonography the overall uterine volume was determined as well as the size of each myoma and the endometrial thickness and characteristics. RESULTS: No statistically significant difference was detected between the two groups at any time during treatment. However, within-group analysis showed a significant increase of uterine volume and of myoma number and size in the estrogen-progestin group, whereas no such increase occurred in the patients treated with tibolone. Also, the mean endometrium width increased significantly from baseline to the end of treatment in the estrogen-progestin group, but not in the tibolone group. CONCLUSIONS: Tibolone seems a valid alternative in menopausal patients with uterine myomas as it provides adequate relief from menopausal symptoms and avoids volume increase of the uterus and myomas.     

醋酸甲羟孕酮增强顺铂对人卵巢癌耐药细胞抗癌作用的研究

目的:观察醋酸甲羟孕酮(MPA)对人卵巢癌CoC1/cDDP细胞移植瘤的生长抑制作用及对DDP的耐药逆转作用,并分析其作用机制。方法:建立人卵巢癌裸鼠皮下移植瘤模型,随机分为4组,每组5只。(1)对照组:腹腔注射等体积生理盐水;(2)DDP治疗组:每只每次腹腔注射DDP 3mg/kg。(3)MPA治疗组:每只每次灌胃30mg/kg;(4)联合治疗组:每只每次灌胃MPA 30mg/kg,1h后每只每次腹腔注射DDP 3mg/kg,每隔2天给药1次,共4次,于治疗第1、5、10、15、20天分别测瘤体积,20天后处死裸鼠,完整剥出瘤组织,称瘤重,计算抑瘤率;通过流式细胞仪检测亚G1期细胞及AnnexinV+/PI-细胞鉴定细胞凋亡,分析移植瘤细胞周期;用半定量RT-PCR法检测移植细胞组织Survivin-ΔEx3、caspase-3、P21WAF1/CIP1及GST-π4基因mRNA表达。结果:(1)MPA组、MPA+DDP组治疗第10天起皮下移植瘤体积明显小于DDP组和对照组,且进行性缩小(P<0.01);抑瘤率分别为51.63%、62.21%,均明显大于DDP组的6.84%(P<0.01),并且两组间有显著差异(P<0.01);(2)流式细胞仪分析显示,移植瘤出现亚G1期峰及AnnexinV+/PI-细胞均证实MPA能诱导CoC1/cDDP细胞凋亡,并显著高于对照组及DDP组,并出现G1期阻滞;与DDP合用除出现G1期阻滞外又出现G2/M期阻滞,S期明显减少,亚G1期细胞及AnnexinV+/PI-细胞进一步上升;(3)半定量RT-PCR检测显示,MPA组Survivin-ΔEx3、GST-πmRNA下调,而P21WAF1/CIP1、caspase-3 mRNA上调,与DDP合用后,对Survivin-ΔEx3、P21WAF1/CIP1及GST-πmRNA的表达无协调作用,而对caspase-3 mRNA有协同上调作用。结论:MPA通过阻滞G0/G1期明显抑制了CoC1/cDDP移植瘤生长,并有很强的致凋亡作用,同时下调GST-πmRNA,从而逆转对顺铂耐药。     

The administration of glucocorticoids for the prevention of ovarian hyperstimulation syndrome in in vitro fertilization: a prospective randomized study.

OBJECTIVE: To determine if the administration of glucocorticoids reduced the rate of ovarian hyperstimulation syndrome (OHSS) in high-risk patients after ovarian stimulation for in vitro fertilization (IVF). DESIGN: Prospective randomized study. PATIENTS: Thirty-one patients who were stimulated with human menopausal gonadotropin (hMG) after pituitary desensitization by gonadotropin-releasing hormone agonist and who developed greater than 20 follicles greater than 12 mm and/or had a serum estradiol (E2) level of greater than 10,000 pmol/L on the day of administration of human chorionic gonadotropin (hCG). INTERVENTIONS: Patients were randomly divided into two groups. Those who were randomized to receive glucocorticoids (group A) (n = 17) were administered intravenous hydrocortisone, 100 mg, immediately after ultrasound (US)-directed oocyte recovery. Prednisolone, 10 mg three times per day, was given for 5 days starting on the day of oocyte recovery followed by prednisolone 10 mg two times a day for 3 days and 10 mg/d for 2 days. Those in group B (n = 14) did not receive any glucocorticoid treatment. In both groups, luteal support was provided by intramuscular injections of gestone 100 mg/d. RESULTS: The two groups of patients were comparable in terms of age, duration of infertility, and total dose of hMG used. All had polycystic ovaries on US examination. On the day of hCG administration, the mean number of follicles in the two groups were 26.76 +/- 2.49 and 25.93 +/- 1.44 and the serum E2 concentration 13,404 +/- 710 and 13,915 +/- 901 pmol/L, respectively. There were no significant differences in the number of oocytes collected or in the fertilization, cleavage, and implantation rates in the two groups. The pregnancy rates per initiated cycle were 41.18% and 35.71%, respectively. Seven of the 17 patients (41.2%) who received glucocorticoids developed ovarian hyperstimulation syndrome compared with 6 of the 14 patients (42.9%) who did not receive glucocorticoids. CONCLUSIONS: Administrations of glucocorticoids to high risk patients did not reduce the rate of OHSS after ovarian stimulation for IVF.     

Low-dosage esterified estrogens opposed by progestin at 6-month intervals

OBJECTIVE: To estimate incidence of endometrial hyperplasia, vaginal bleeding, and menopausal symptoms in women who changed from standard monthly cyclic hormone replacement therapy (HRT) to half-strength estrogen opposed by medroxyprogesterone acetate (MPA) at 6-month intervals. METHODS: We identified 138 women aged 55-75 years who had regularly used HRT at a standard dosage (equivalent to 0.625 mg conjugated estrogen) opposed by cyclic monthly MPA. Each subject's HRT regimen was changed to 0.3 mg/day esterified estrogens (Estratab; Solvay Pharmaceuticals, Marietta, GA) combined with 14-day courses of MPA, 10 mg/day, every 6 months. Endometrial biopsy was repeated after 1 year of the new regimen. Any vaginal bleeding was reported in each patient's daily diary. Menopause symptoms were evaluated using the Greene Menopause Symptom Index. RESULTS: Among 125 women who had biopsy after 1 year of the new regimen, endometrial hyperplasia was found in two (1.6%, 95% confidence interval 0.3%, 6.2%). Of the 125 women, 44% had scheduled bleeding, and 9.4% had unscheduled bleeding. Relative to baseline vasomotor score (range 0-6), an increase of at least 2 U was reported by 20% of subjects at 6 months and by 17% of subjects at 12 months. CONCLUSION: Most women aged at least 55 years can safely switch their HRT regimen from standard dosage HRT to low-dosage estrogen opposed by MPA at 6-month intervals. Moreover, this new HRT regimen causes little vaginal bleeding while maintaining adequate control of menopausal symptoms.     

Evaluation of the effects of various gestagens on insulin sensitivity, using homeostatic model assessment, in postmenopausal women on hormone replacement therapy.

The objective of the present study was to compare the effects of various gestagens on insulin sensitivity in postmenopausal women on hormone replacement therapy (HRT). This prospective study enrolled 156 postmenopausal women who had menopausal status for at least 6 months. Group 1 was treated with 17 beta-estradiol (E2; 2 mg) plus norethisterone acetate (NETA; 1 mg); Group 2 was given E2 (2 mg) plus medroxyprogesterone acetate (MPA; 2.5 mg); Group 3 was given E2 (2 mg) plus dydrogesterone (DG; 10 mg); and Group 4 was given E2 (2 mg) plus micronized progesterone (MP; 100 mg). Group 5 was the surgical menopausal group and was given only E2 (2 mg) continuously. All 156 subjects completed the 3-month follow-up on the trial. The patients were analyzed by using homeostatic model assessment (HOMA) for insulin sensitivity before treatment and 3 months after treatment, comparing the effects of various HRT regimens on insulin sensitivity. No significant differences were found in the baseline characteristics of the patients (p > 0.05). There were no significant differences in mean values of HOMA before HRT among the five groups (p > 0.05). There were statistically significant differences in mean values of HOMA only in Group 1 (E2 + NETA) and Group 3 (E2 + DG) after HRT (p > 0.05). E2 + NETA and E2 + DG were found to improve insulin sensitivity in postmenopausal women after 3 months of treatment, whereas E2 + MPA, E2 + MP and E2 only did not show such an effect in postmenopausal women.