Changes Xsin Central Circulation in Premenopausal Women During Application of an Estradiol Valerate ‐ Norgestrel Combination (CyclabilR)

The orthostatic circulatory reaction, the physical working capacity on a bicycle ergometer, the indirectly measured blood pressure at rest and after the ergometer test, the total hemoglobin content, blood volume and the heart volume in supine position were all determined on three separate occasions in the 17 premenopausal women who were taking an estrogen-progestogen combination as premenopausal substitution (2 mg estradiol valerate and 0.5 mg norgestrel, CyclabilR, Schering AG). Twelve women not receiving steroid treatment served as controls. The examinations were performed once prior to the commencement of the medication and 6 and 12 months thereafter. The orthostatic pulse reaction, the physical working capacity, the total amount of hemoglobin and heart volume did not change during the 12 months. Heart volume increased in both groups but there was no difference between the groups. Systolic and diastolic blood pressure increased slightly in the treated group during the first months but returned towards the initial values at 12 months. The transitory blood pressure increase when using the estrogen-progestogen combination in the premenopause during 12 months is similar to that earlier reported in younger women taking low-dose steroid contraceptives (8). It is conceivable that an adaptative mechanism in the vascular system will work in both situations.