Transdermal estradiol in the treatment of hypergonadotropic and normogonadotropic ovarian insufficiency patients

Abstract

Objective: to investigate influence of the transdermal estrogen — CLIMARA on clinical, hormonal and sonographic features in hypergonadotropic and normogonadotropic ovarian insufficiency patients.

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Methods: We observed 9 patients with hypergonadotropic amenorrhea (group I) and 11 normogonadotropic ovarian insufficiency patients (group II) in age between 17-45years old, mean age was 28,6(2,4 year. Transdermal estrogen was given by common way. Noretisterone-5mg was added at last week. Treatment duration was 6 cycles. Hormonal examination was performed by immunoferment assay before and at 3-rd and 6-th treatment cycles. Ultrasound examination was managed at the same time. Individual acceptability, side effects was evaluated, breast examination before and after treatment was provided. Occurrence and regularity of menstrual reactions was controlled. Statistical analysis was based on Student criteria.

Results: Generally good acceptability without significant side effects was observed. During treatment patients from both groups had regular menstrual reactions. There was slight breast enlargement without adenomatosis. In both groups of patient’s significant elevation of blood estradiol levels was detected (group I: from 135,6(24,7pmol/l to 323,2(39,3pmol/l; group II: from 178,6(26,4pmol/l to 404,2(38, lpmol/l; p<0,0001). Changes at plasma prolactin levels had no statistical importance. FSH and LH blood concentrations in group I decreased significantly (p <0.001), in group II- FSH and LH levels had no significant differences. Endometrial thickness increases during therapy in both groups of patients (I group: from 0,07(0,03cm to 0,32(0,02cm; II group: from 0,15(0,03cm to 0,33(0,04cm, p<0.001). Endometrium was proliferative in all patients.

Conclusion: Transdermal estrogen Climara (Shering AG) is well acceptable, induces elevation of plasma estradiol levels along with adequate endometrial reaction and could be used in hormonal replacement therapy at hypergonadotropic and normogonadotropic patients of reproductive age.