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Transdermal menopausal hormone therapy: delivery through skin changes the rules
1Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley, Providence, Rhode Island 02905, USA. jbuster@wihri.org
Expert Opinion on Pharmacotherapy
|April 30, 2010
Summary
Transdermal hormone therapy with estradiol and testosterone offers significant safety and efficacy advantages over oral options for postmenopausal women. This approach enhances quality of life by bypassing liver metabolism, improving treatment for vasomotor symptoms and hypoactive sexual desire disorder.
Area of Science:
- Endocrinology
- Gynecology
- Pharmacology
Background:
- Transdermal hormone therapy is emerging as a safer alternative to oral estrogens and androgens for improving postmenopausal women's quality of life.
- Direct skin absorption bypasses hepatic first-pass metabolism, preserving the efficacy of estradiol and testosterone.
Purpose of the Study:
- To critically review recent clinical trials on transdermal estradiol and testosterone in postmenopausal women.
- To evaluate the safety and efficacy of these transdermal hormone therapies.
Main Methods:
- Review of recent clinical trials focusing on transdermal estradiol and testosterone use.
- Analysis of efficacy in treating vasomotor symptoms and hypoactive sexual desire disorder.
- Assessment of safety profiles compared to oral hormone therapy.
Main Results:
- Transdermal estradiol effectively treats vasomotor symptoms with improved safety compared to oral estrogens.
- Transdermal testosterone is proven effective for hypoactive sexual desire disorder in well-powered randomized trials, demonstrating high safety.
- Properly selected postmenopausal women experience significant and safe quality of life enhancements.
Conclusions:
- Transdermal estradiol and testosterone offer superior safety and efficacy over oral preparations for postmenopausal hormone therapy.
- These transdermal therapies are poised for increased popularity and may replace oral hormone therapy.
- Clinical use of transdermal estradiol for VMS and testosterone for HSDD presents significant advantages.
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