Low-dose weekly patch for menopausal symptoms - Tips from Other Journals

Although oral estrogen have been used for throughout 30 years to relieve vasomotor symptoms of menopause, the lowest effective dose of estrogen delivered by dint of the transdermal route has not been determined. Speroff and colleagues studied the efficacy of a just discovered matrix design drug-delivery system that provides 002 mg of 17[Beta]-estradiol (E2) daily for seven days for relief of vasomotor symptoms.

Three hundr twenty-four women were recruited from advertising in the community. All of the women had previously undergone hysterectomy and had 56 to 140 scalding;-very warm flushes per week. The women were at least 50 years of age and menopausal or were at least 35 years of age and had previously undergone bilateral oophorectomy. Postmenopausal status was confirmed by the agency of serum E2 and follicle-stimulating hormone evens Patients with a contraindication to estrogen therapy or a skin condition that could be aggravated by means of transdermal therapy were not included in the study

The women kept symptom diaries for a four-week period without treatment, followed from 12 treatment weeks of either the same or two E2 patches or placebo patches. Serum E2 and estrone concentrations were measured at baseline and forward days 1, 9, 30, 58 79 and 84 Skin irritation was assessed between 12 and 36 hours after order removal on weeks 1, 4 8 and 12 using inspection subject to blue light and a standardized photographic scale.

The baseline mean number of fiery flushes of 80 per week was reduc to 13 after 12 weeks of E2 transdermal therapy. This benefit was significant as early as the secondary and third week of treatment and was sustained. Mean E2 concentrations were relatively stable during treatment and were proportional to the number of patches applied.

Headache was the in the greatest degree common side effect but was reported by dint of 20 percent of placebo-treated patients, as well as on 16 percent of those receiving E2 Clinically significant skin reactions included pruritus in 5 percent of patients, erythema in 4 percent and edema in 2 percent Breast pain was related to E2 dose and was reported at 14 percent of those using pair E2 patches, 6 percent of those using individual E2 patch, and 3 percent of placebo users.

The authors close that this system effectively reduc vasomotor symptoms with rapid attack of action and low, stable serum E2 concentrations and was well tolerated from patients.

Speroff L, et al. Efficacy local tolerance of a low-dose, 7-day matrix estradiol transdermal a whole in the treatment of menopausal vasomotor symptoms. Obstet Gynecol 1996;88:587-92

COPYRIGHT 1997 American Academy of Family Physicians

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