A prospective randomized comparative study of the effects of intranasal and transdermal 17 beta-estradiol on postmenopausal symptoms and vaginal cytology.
BACKGROUND
Investigating the adverse effects of oral hormone replacement therapy (HRT), the clinical effectiveness of alternative combinations and route of administrations.


OBJECTIVE
To compare the effects of intranasal and transdermal 17 beta-estradiol combined with vaginal progesterone on vasomotor symptoms and vaginal cytology.


METHODS
A 12-week, prospective, randomized comparative study was conducted between July 2005 and September 2006.


METHODS
Eighty postmenopausal women aged between 42-57 years, who had scores of > or =1.7 on the menopause rating scale-I (MRS-I) items "1-6", were randomly assigned to receive intranasal (300 microg/day, n =40) or transdermal (50 microg/day, n =40) 17 beta-estradiol continuously. All patients also received a vaginal progesterone gel twice weekly. Vasomotor symptoms were evaluated at weeks 0, 4, 8 and 12. Vaginal maturation index (VMI) was evaluated at weeks 0 and 12 of the study.


METHODS
The Mann-Whitney U and the Wilcoxon tests were used. P < 0.05 was regarded as significant.


RESULTS
Thirty-two women in the intranasal and 29 women in the transdermal group completed the study. The total score of the MRS, the sum-scores of Factor 1 "HOT FLUSHES" and Factor 2 "PSYCHE" significantly decreased in both groups at week 4. Factor 3 "ATROPHY" scores significantly decreased only in the transdermal group at week 12. The VMI showed no changes within and between the two groups at the end of the study.


CONCLUSIONS
Intranasal and transdermal 17beta-estradiol combined with vaginal progesterone gel as a continuous HRT caused a similar decrease in vasomotor symptoms but did not have any significant effect on VMI after 12 weeks of treatment in this study population.
Odabaşi
A R
AR
Adnan Menderes University Faculty of Medicine, Department of Obstetrics and Gynecology, 09100 Aydin, Turkey. arodabasi@gmail.com
Yüksel
H
H
Demircan
S S
SS
Kaçar
D F
DF
Culhaci
N
N
Ozkara
E E
EE
D000279:Administration, Cutaneous; D000281:Administration, Intranasal; D000282:Administration, Intravaginal; D000328:Adult; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects* / Q000502:physiology / Q000523:psychology; D011374:Progesterone / Q000008:administration & dosage; D011372:Progestins / Q000008:administration & dosage; D011446:Prospective Studies; D014621:Vagina / Q000187:drug effects* / Q000473:pathology
D004967:Estrogens; D011372:Progestins; D011374:Progesterone; D004958:Estradiol