title: Self-adjusted postmenopausal hormone replacement therapy: effects on the biological and immunological profile of FSH and correlation to climacteric symptoms.
abstract: OBJECTIVE
  The purpose of the present study was to evaluate the hormonal profile of patients of postmenopausal age during estrogen replacement therapy (ERT) with special reference to the serum levels of biologically active FSH (B-FSH) in a self-adjusted ERT model.
  
  
  METHODS
  The hormonal values found have been correlated to climateric symptoms reported by the patients (scored by the Kupperman menopausal index (KI)).
  
  
  METHODS
  B-FSH was measured using an assay based on a cell system transfected permanently with FSH receptor cDNA. All women (n=32) applied estradiol percutaneously using 1 mg estradiol-17beta (E(2)) as an initial dose and were encouraged to increase the daily dose until they felt comfortable according to a specific scheme. Twelve of the 32 women were hysterectomized and treated, accordingly, with ERT only; 20 women received megestrol acetate monthly for 10 days.
  
  
  RESULTS
  The initial average KI was 30 (range 10-54). A high degree of correlation (r=0.83; P<0.001) was observed between B-FSH and immunologically active FSH (I-FSH). Serum I-FSH and E(2) correlated negatively (r=-0.21; P<0.001); similarly, a negative correlation (r=-0.15; P<0.01) was observed between serum B-FSH and E(2) levels. Serum I-FSH and KI showed modest but significant positive correlation (r=0.13; P<0.01); a somewhat higher degree of correlation (r=0.19; P<0.005) was observed when B-FSH and KI were compared. E(2) showed positive correlation to serum sex-hormone binding globulin levels (r=0.22; P<0.001).
  
  
  CONCLUSIONS
  This study shows that the transdermal self-adjusted hormone replacement therapy (HRT) model introduced is suitable for studies on endocrine changes during postmenopausal ERT. The finding of poor correlation between serum E(2) levels and KI emphasizes the importance of hormonal measurements during postmenopausal HRT.
authors.affiliation: Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Vihtamaki
authors.forename: Manuela
authors.initials: M
authors.lastname: Simoni
authors.forename: Risto
authors.initials: R
authors.lastname: Tuimala
authors.forename: Eberhard
authors.initials: E
authors.lastname: Nieschlag
authors.forename: Kimmo K
authors.initials: KK
authors.lastname: Vihko
mesh_terms: D002979:Climacteric / Q000523:psychology*; D004958:Estradiol / Q000008:administration & dosage / Q000097:blood; D015914:Estrogen Replacement Therapy; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D011962:Receptors, FSH / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism
chemical_list: D011962:Receptors, FSH; D012738:Sex Hormone-Binding Globulin; D004958:Estradiol; D005640:Follicle Stimulating Hormone