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Comparison of gel and patch estradiol replacement in Brazil, a tropical country
Travassos de Figueiredo Alves1, M Amélia Sobreira Gomes, R Clapauch
1Division of Women's Endocrinology, Department of Endocrinology, Hospital da Lagoa, Ministry of Health, Rio de Janeiro, Brazil. solangefig@openlink.com.br
Objectives:
Compare the administering technique, local tolerance and clinical and laboratory response to hormone replacement therapy with 17-beta estradiol in gel and patch in Brazil, a tropical country.
Methods:
We carried out a transversal study by means of an outpatient interview completed by 66 menopausal women, 42 using gel, and 24 utilizing patches. We focused on the main problems with the two forms of replacement, in summer and at other times during the year.
Results:
The average daily dose of 17-beta estradiol administered was 150 microg in the GEL GROUP and 50 microg in the PATCH GROUP. Reports of itching (33.3%) and local skin reactions (54. 2%) occurred exclusively in the PATCH GROUP. The patches came detached in 54.2% of the patients. These problems were more frequent in the summer. There was no significant difference in the regularity of administering (P=0.38) nor in the levels of FSH (P=0.16) and LH (P=0.33) between the two groups. Problems with the application technique (P=0.002) and the blood levels of estradiol (P=0.0002) were greater in the GEL GROUP, while symptoms of hypoestrogenism predominated in the PATCH GROUP (P=0.002).
Conclusions:
We concluded that, in our environment, the use of 17-beta estradiol in gel presented fewer local skin reactions, was more effective in alleviating the symptoms of hypoestrogenism and had better acceptance in hormone replacement therapy for menopausal women, as compared with the 17-beta estradiol patch.