Transdermal estrogen therapy in menopause. Eighteen months follow-up

In this study we evaluated different metabolic parameters and bone mass, before and after 18 months of treatment by transdermal estradiol associated with oral sequential MPA in menopause. We treated 46 physiologically postmenopausal patients (44-55 years old) for at least six months, by TTS/E2 50 mcg for 3 weeks and MPA 10 mg for the last 12 days of estradiol treatment. The fourth week was free of therapy. Before treatment and after 18 months, we evaluated bone density (BMC/BW), body mass index (W/sqH), systolic and diastolic blood tension, lipid parameters, coagulation parameters, mineral metabolism with statistical elaboration of our results. After therapy we found a significant decrease in diastolic blood tension, a significant reduction in triglyceride levels and a slight but significant increase in HDL-cholesterol levels. The only variation in coagulation parameters was a decrease of circulating fibrinogen. No variation occurred in the body mass index, mineral metabolism or bone density. In conclusion even long term transdermal treatment seems metabolically well tolerated and very useful in relieving neurovegetative climacteric symptoms and dystrophic genital ones.