happy menopause, a local estrogen progesterone therapy

ABSTRACT

The estradiole/progestagen transdermal therapeutic system [TTS-0.05 mg.] is a cutaneous device which delivers estradiole into the systemic circulation via the stratum corneum at a constant rate for up to 4 days. physiological levels of estradiole [the major estrogen secreted by the ovaries in premenopausal women] can therefore be maintained in postmenopaual women with daily doses because first pass hepatic metabolism is avoided. We studied the beneficial effects of transdermal estradiole/ progestagen on the plasma gonadotrophin, lipids, maturation of vaginal epithelium, endometrium and menopausal symptoms [hot flushes, sleep disturbances mood]. All these were found to be comparable to studies on oral estrogen, while the undesirable effects of oral estrogen on hepatic metabolism are avoided. As with oral estrogen treatment, concomitant sequential local progestagen was recommended for patients with intact uterus, in order to reduce endometrial stimulation. Transdermal estrogen/ progestagen replacement treatment was well tolerated by patients, with local irritation at the site of application, being the most common adverse effect. Through this study we may state that transdermal estradiole offers a near physiological estrogen replacement in menopausal women in a convenient low dose form which may avoid some of the complications of higher dose oral therapy