The Clinical Efficacy of Transdermal Estrogen[Betadiol] in the Treatment of Postmenopausal Symptoms

Choi, Y M; Park, S Y; Koo, S Y; Lee, H S; Suh, C S; Kim, S H; Kim, J K; Moon, S Y; Lee, J Y

Abstract

OBJECTIVE
To assess the efficacy of estradiol patch in relief of menopausal symptoms and to determine the incidence of skin irritation symptoms in postmenopausal women.
METHODS
Study subjects were the 60 postmenopausal women who complain menopausal symptoms such as flushing, insomnia, urinary frequency, vaginal dryness or depression. The estradiol patch[Betadiol , 2.5 mg] was applied twice weekly over a period of 12 weeks, and oral medroxyprogesterone acetate[10 mg] was taken by non-hysterectomized patients. The measurement of serum estradiol, lipid profile, urine calcium/creatinine ratio and deoxypyridinoline was performed. The menopausal symptoms and the skin irritation symptoms were evaluated with history taking and the patient diary.
RESULTS
The mean age was 54.0+/-4.9 years[mean+/-SD] and the mean menopausal duration was 5.0+/-4.8 years. All patients out of 40 women experienced improvement of flushing symptoms, and 25 out of 27[92.6%], 21 out of 23[91.3%], 37 out of 41[90.2%], and 20 out of 24[83.3%] patients showed improvement of insomnia, urinary frequency, vaginal dryness and depression[p<0.01]. The incidence of severe skin irritation symptoms were 15% in case of erythema, and 11.7% in pruritus, but none of the patients quit the dropped out during the study because of due to skin symptoms. The serum level of total cholesterol and LDL cholesterol decreased significantly to 202.0+/-4.2 mg/dl[mean+/-SE] and 122.8+/-4.0 mg/dl, respectively[p<0.01]. There were also significant decrease in urine calcium/creatinine ratio and deoxypyridinoline level[0.09+/-0.01, p<0.01; 6.5+/-0.3 nM/mM creatinine, p=0.02].
CONCLUSION
The estradiol patch was very effective regarding alleviation of menopausal symptoms. There was increase in serum estradiol concentration, improvement of serum lipid profile and decrease in urine marker level for bone resorption after application of estradiol patch. Although some patients experienced skin irritation symptoms, but they were usually mild in severity in most cases. The estradiol patch may provide a good alternative of estrogen replacement therapy of postmenopausal women.