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Transdermal Oestrogen for Postmenopausal Women: A Double Blind Crossover Comparative Study with Ethinyl Oestradiol
Author(s) -
Pattison N. S.,
Uptin T.,
Knox B.,
France J.
Publication year - 1989
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1989.tb02879.x
Subject(s) - transdermal , medicine , crossover study , menopause , estrogen , adverse effect , endocrinology , estrone , pharmacology , placebo , alternative medicine , pathology
EDITORIAL COMMENT: The importance of postmenopausal symptoms and whether or not they can be safely controlled is undeniable — the 3 main considerations are patient compliance, complications and cost. This paper shows that transdermal administration of oestradiol was a clear winner in comparison with oral ethinyl oestradiol, although the important entity of osteoporosis was not addressed in this study. The findings reported in this paper are of more than academic interest; the trial warrants verification with a larger number of patients, and other oral oestrogen preparations (oestriol, oestrone, oestradiol) should be compared with transdermal and subcutaneous oestradiol therapy. We will be pleased to publish the findings of such studies in this journal. The pattern of uterine bleeding with different treatment regimens warrants careful documentation, since the return of menstruation is often the reason patients give for discontinuation of hormone replacement therapy. Summary: A double blind crossover study of transdermal oestradiol (50ug/ day) and ethinyl oestradiol (20ug/day) was conducted with 25 postmenopausal women. Transdermal oestradiol increased circulating levels of oestradiol and oestrone. Both preparations favourably improved patients' symptoms and vaginal cytology, lowered gonadotrophin levels and urinary calcium loss and gave a satisfactory menstrual pattern, Transdermal oestradiol had no effect on measures of hepatic function whereas oral ethinyl oestradiol significantly altered levels of sex hormone binding globulin, plasma renin substrate and lipoproteins. Transdermal oestradiol has a comparable beneficial effect on postmenopausal symptoms to ethinyl oestradiol without the adverse effects on hepatic proteins.