Salmon calcitonin plus intravaginal estriol: an effective treatment for the menopause.
OBJECTIVE
Intravaginal estriol (E3) effectively improves postmenopausal genito-urinary disturbances, without stimulating endometrial proliferation. The aim of the present study was to evaluate the effect of intravaginal estriol (E3) plus nasal spray salmon calcitonin (sCT), to improve neurovegetative symptoms and to prevent the decline of bone mineral density (BMD) of postmenopausal women.


METHODS
Two hundred and fourteen (214) healthy postmenopausal women were treated for 12 months with: (1) E3 (0.5 mg every other day) + Ca (0.5 g/day); (2) E3 + Ca + sCT (50 IU x 2/day); (3) sCT + Ca; (4) Ca. Climacteric complaints, such as hot flushes and sweating, BMD at the distal 1/10 of the radius, analyzed by dual photon absorptiometry, urinary excretion of hydroxyproline and serum alkaline phosphatase were evaluated at baseline and every 6 months. At the same time, patient compliance and drug tolerability were evaluated.


RESULTS
E3 but not sCT, improved hot flushes and sweating. E3 blunted but not completely counteracted the BMD decline observed in women treated with only Ca, and reduced urinary hydroxyproline excretion. sCT markedly increased BMD values and reduced both urinary hydroxyproline excretion and serum alkaline phosphatase. These effects were not potentiated by E3 coadministration. All treatments were well tolerated.


CONCLUSIONS
Present data indicate that the combined administration of intravaginal E3 and sCT may represent an alternative therapeutic regimen for those postmenopausal women who do not accept or have contraindications to classical hormone replacement therapy.
Melis
G B
GB
Istituto di Ginecologia Ostetricia e Fisiopatologia della Riproduzione Umana, Ospedale S. Giovanni di Dio, Cagliari, Italy.
Cagnacci
A
A
Bruni
V
V
Falsetti
L
L
Jasonni
V M
VM
Nappi
C
C
Polatti
F
F
Volpe
A
A
D015502:Absorptiometry, Photon; D000281:Administration, Intranasal; D000282:Administration, Intravaginal; D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D015519:Bone Density / Q000187:drug effects; D002116:Calcitonin / Q000008:administration & dosage / Q000627:therapeutic use*; D002979:Climacteric / Q000187:drug effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D004714:Endometrial Hyperplasia / Q000517:prevention & control; D004964:Estriol / Q000008:administration & dosage / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control; D010349:Patient Compliance; D017698:Postmenopause / Q000187:drug effects; D011884:Radius / Q000187:drug effects; D012474:Salmon; D013546:Sweating / Q000187:drug effects
D002116:Calcitonin; D000469:Alkaline Phosphatase; D004964:Estriol; D006909:Hydroxyproline