Low-dose transdermal hormone therapy (HT) remains a viable short-term alternative for women to treat debilitating menopausal symptoms, offer lipid protection and
preserve bone health, despite the negative news about oral HT effects from the Women's Health Initiative (WHI).
These findings were revealed by a recent review of peer-reviewed medical studies by Mary Jane Minkin, of Yale University School of Medicine, in the April issue of the Journal of Reproductive Medicine.
"There is a lot to consider when interpreting the WHI results. The fact is that millions of women still suffer from the potentially devastating symptoms of menopause - so much so that their quality of life deteriorates", said Dr. Minkin, clinical professor in the Department of Obstetrics and Gynecology at Yale.
"Hormone therapy remains the most effective means to relieve vasomotor symptoms, and certain estrogen formulations and routes of administration that were not studied in WHI offer different health effects that may offer several advantages," she noted.
Unexpected results from the WHI published in June 2002 called into question the safety of all HTs - even though investigators only examined oral HTs that used conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA).
The researchers cautioned that the WHI results did not necessarily apply to other doses of CEE/MPA, to other types of oral estrogens and progestins, or to other estrogens and progestins delivered by different routes.
"Reproductive healthcare professionals may find it difficult to counsel their patients who suffer from severe menopausal symptoms about appropriate treatment because not all estrogens and progestins are alike. Alternative drugs, doses and delivery systems may exhibit better safety profiles than CEE/MPA formulations, with no loss of efficacy," Dr. Minkin added.
Transdermal, unlike oral, HT delivery bypasses the liver, permitting the use of estrogen doses that are substantially less than in pills, thereby reducing the risk of certain adverse effects while providing benefits, according to the review.
Transdermal formulations of the transdermal estradiol (E2) offer relief of such menopausal symptoms as hot flashes, night sweats and disturbed sleep that affect patients' quality of life.