OJPM  Vol.1 No.2 , August 2011
Symptomatic changes in postmenopause with different methods of hormonal therapy
ABSTRACT
Objective: The diversity of opinions on the adverse effects of medications used to treat postmenopausal symptoms has prompted the use of various routes and mechanisms of action that need to be explored because bioavailability of the medications can vary. In order to select the appropriate route of administration for hormonal therapy (HT), it is necessary to determine baseline therapeutic efficacy. Design: We designed a prospective, randomized study consisting of four groups of postmenopausal wo-men: group 1 received oral conjugated estrogens, group 2 received a synthethic steroid, group 3 received estradiol nasally in spray form, and group 4 used transdermal estradiol in the form of patches. Criteria used to evaluate effectiveness was the Greene scale, which evaluate six components. These criteria were applied to each patient before hormonal intervention and then each month for 6 months. Luteinizing hormone (LH), follicle stimulating horone (FSH) and estradiol concentration were determined by chemiluminescence. Student’s t-test was used for intra-group comparisons before and after treatment. Results: There was a significant decrease in the vasomotor and sexual component (p < 0.05) with the use of four HT types. For depression, a difference was observed with synthetic steroids and oral estrogens. Upon analyzing the somatic component there was a decrease in symptoms with nasal and transdermal routes. Psychological changes were observed with the use of oral synthethic steroids and transdermal patches. Anxiety component demonstrated differences with nasal spray and oral estrogens, although all HT forms in this component showed a pattern of irregular changes. Conclusions: Changes in the response could be due each route of administration and medication used. Absorption variability may exist, which has repercussions in the control of symptoms and should be taken into consideration when selecting the appropriate route of administration for patients beginning HT.

Cite this paper
nullHernández-Valencia, M. , Cordova, N. , Vargas, A. , Basurto, L. , Saucedo, R. , Vargas, C. , Ruiz, M. , Manuel-Apolinar, L. and Zárate, A. (2011) Symptomatic changes in postmenopause with different methods of hormonal therapy. Open Journal of Preventive Medicine, 1, 20-24. doi: 10.4236/ojpm.2011.12004.
References
[1]   Hansen LB, Portman D. Hormone therapy update. Current recommendations for menopausal symptoms. US Pharm 2006;31:86-89.

[2]   Smith AL, Wein AJ. Estrogen replacement therapy for the treatment of postmenopausal genitourinary tract dysfunction. Discov Med. 2010;10:500-510.

[3]   Dennerstein L, Lehert P. Women’s sexual functioning, lifestyle, mid-age, and menopause in 12 European countries. Menopause 2004;6:778-785.

[4]   Reimer A, Johnson L. Atrophic vaginitis: signs, symptoms, and better outcomes. Nurse Pract. 2011;36:22-28.

[5]   Kingsberg S, Kellogg S, Krychman M. Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy.Int J Womens Health 2010;9:105-111.

[6]   Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002;288:321-333.

[7]   Bond S, Horton LS. Management of postmenopausal vaginal symptoms in women.. J Gerontol Nurs. 2010;36:3-7.

[8]   Lacroix AZ, Chlebowski RT, Manson JE, Aragaki AK, Johnson KC, Martin L, Margolis KI, Stefanick MI, Brzyski R, Curb JD, Howard BV, Lewis CE, Wactawski-Wende J. Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hysterectomy. JAMA 2011;30:1305-1314.

[9]   Lowe DA, Baltgalvis KA, Greising SM. Mechanisms behind estrogen's beneficial effect on muscle strength in females. Exerc Sport Sci Rev 2010;38:61-67.

[10]   Basurto L, Saucedo R, Zarate A, Martinez C, Gamino CE, Reyes E, Hernandez-Valencia M. Effect of pulsed estrogen therapy on hemostatic markers in comparison with oral estrogens regimen in postmenopausal women. Ginecol Obstet Invest 2006;61:61-64.

[11]   Hernández-Valencia M, Córdova-Pérez N, Basurto L, Saucedo R, Vargas C, Vargas A, Ruiz M, Manuel L, Zárate A. Frequency of symptoms of the climacteric syndrome. Ginecol Obstet Mex. 2010;78:232-237.

[12]   Henderson VW. Action of estrogens in the aging brain: dementia and cognitive aging. Biochim Biophys Acta 2010;1800:1077-1083.

[13]   Rachon D, Suchecka-Rachon K, Hak L, Mysliwska J. Effects of intranasal 17-? estradiol administration on serum bioactive interleukin-6 and C-reactive protein levels in healthy postmenopausal women. Menopause 2006;5:840-845.

[14]   Gompel A. Molecular action of estrogens and anti-estrogens. Maturitas 2006;54:313-314.

[15]   Simoncini T, Mannella P, Fornari L, Caruso A, Varone G, Garibaldi S, Genazzani A. Tibolone activates nitric oxide synthesis in human endothelial cells. J Clin Endocrinol Metab 2004;89:4594-4600.

[16]   The Women’s Health Initiative Steering Committee. Effects of conjugated equine estrogens in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized, controlled trial. JAMA 2004;291:1701-1712.

 
 
Top