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Transdermal estrogen, intermittent progesterone safe, effective for menopause symptoms

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Reducing the dosage of progesterone in postmenopausal women on low-dose transdermal hormone therapies provided safe and effective relief of menopausal symptoms, according to recent study findings presented at The North American Menopause Society Annual Meeting.

“We attempted to postulate the optimal HT combination for women with a uterus based on current knowledge of risks and benefits of HT,” Wendy L. Wolfman, MD, FRCSC, of the University of Toronto, told Endocrine Today.

Wendy L. Wolfman

Wolfman and colleagues evaluated 155 postmenopausal women using transdermal 17-beta estradiol 25 µg (n = 38) or 37.5 µg (n = 117) paired with oral progesterone 100 mg for 3 to 5 days a week. The researchers sought to determine the safety and efficacy of reducing the progesterone dosage of continuous HT with continuous transdermal estrogen.

“The transdermal modality for estrogen was chosen to reduce possible thrombotic risk,” Wolfman said. “The dosage of progesterone can be reduced in women on low-dose transdermal therapies with safe results while still producing good symptom relief.”

All participants experienced relief of postmenopausal vasomotor symptoms.

More than half (55.48%) of participants underwent transvaginal ultrasound at least 1 year after using the low-dose therapy. Endometrial thickness was, on average, 3.9 mm. Nearly 70% of participants had endometrial thickness of less than 5 mm.

Just 5% of participants experienced vaginal or breakthrough bleeding, and there were no abnormal endometrial biopsies. All mammogram reports were normal.

“The regimen was well tolerated with excellent symptom efficacy, few side effects, low incidence of breakthrough bleeding and good compliance and no serious medical complications,” Wolfman said. “The purpose of the intermittent use of progesterone was to improve receptor response via down regulation and reduce total progesterone dosage for the breast while maintaining endometrial safety.” – by Amber Cox

Reference:

Gomaa HA, et al. P-27. Presented at: The North American Menopause Society Annual Meeting; Sept. 30-Oct. 3, 2015; Las Vegas.

Disclosure: Endocrine Today was unable to confirm any relevant financial disclosures.