Hormonal and metabolic effects of transdermal estradiol/progestagen administration in postmenopausal women

Objective - To evaluate the effects on hormonal and metabolic variables and bone density of a transdermal system delivering estrogen and progestagen. Design - Twenty-one patients were included in the study and randomly assigned to the following treatments: group A was treated with transdermal 17β- estradiol, 50 μg/day (Estraderm TTS 50), from the first to the fourteenth day of the cycle and with a transdermal combination of 17β-estradiol (50 μg/day) and norethisterone acetate (NETA) 250 μg/day during the following 14 days; group B was treated with Estraderm TTS 50 from the first to the twenty-eighth day, adding oral medroxyprogesterone acetate (MPA), 10 mg/day, during the final 14 days. DHEAS, testosterone, SHBG, prolactin, gonadotropins, and estrogens were measured in basal conditions and after 6 months' therapy. In the same schedule, lipid patterns (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides), phosphocalcium variables (osteocalcin, calcitonin, parathormone), and bone mineral density were also studied. Results - Both treatments were efficient in reducing menopausal symptoms. An increase of DHEAS (P < .05) and a decrease of FSH and LH (P < .02, <.01, respectively) were observed in group B. No significant modifications in lipid and lipoprotein metabolism were shown in either group after 6 months. The calcium-regulating hormone osteocalcin (BCG) decreased significantly (P < .05) only in group A; calcitonin, parathormone, and bone density were unchanged after treatment. Conclusion - Transdermal administration of estrogen plus progestagen reduces menopausal symptoms, but does not induce changes in metabolic variables and hormonal levels (androgens and prolactin).