Absorption of vaginal estrogen cream during sexual intercourse: a prospective, randomized, controlled trial.
OBJECTIVE
To determine if intercourse changed serum estradiol levels in women using vaginal E2 cream or in their male partners.


METHODS
Prospective, randomized, placebo-controlled, crossover, blinded study of 10 postmenopausal women and their male sexual partners. Subjects were randomized to estradiol or placebo cream and intercourse, then crossed over after 7-14 days. Seven to 14 days later, the woman used vaginal estradiol cream and abstained from intercourse. Serum E2 levels were obtained 10-12 hours after each exposure.


RESULTS
Serum E2 levels were higher in 8 of 10 men after intercourse with vaginal estradiol cream, and this resulted in a small but significant (p = 0.03) increase in the estradiol levels as compared to placebo. Paradoxically, intercourse resulted in markedly lower estradiol levels in women as compared to abstinence (p = 0.004).


CONCLUSIONS
Men absorb vaginal estradiol during intercourse, whereas intercourse reduces estradiol absorption in women. Although serum estradiol levels were only mildly elevated in men, it is possible that long-term exposure could cause feminizing changes. In women, estradiol levels were markedly reduced by intercourse.
Hurst
Bradley S
BS
Department of Obstetrics and Gynecology, Carolinas Medical Center, P.O. Box 32861, Charlotte, NC 28232, USA. bhurst@carolinas.org
Jones
Allyson I
AI
Elliot
Mollie
M
Marshburn
Paul B
PB
Matthews
Michelle L
ML
D000042:Absorption / Q000187:drug effects*; D000282:Administration, Intravaginal; D003075:Coitus; D003270:Contraceptive Agents / Q000378:metabolism*; D018592:Cross-Over Studies; D004958:Estradiol / Q000097:blood / Q000378:metabolism*; D004967:Estrogens / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood; D011446:Prospective Studies; D012737:Sex Factors
D003270:Contraceptive Agents; D004967:Estrogens; D004958:Estradiol