[Postmenopausal estrogen therapy. Recent aspects of parenteral administration of 17-beta estradiol]

Oral treatment with micronized 17-beta-oestradiol or oestradiol valerate in daily doses of 2 mg postmenopausally resulta in plasma concentrations of free oestrone which are more than double the concentrations in fertile women and plasma oestradiol concentrations which only comprize 20-25% of the oestrone concentrations. On oral treatment, the metabolism in the liver is influenced and this results in increased synthesis of a series of plasma proteins in the liver and changes in lipid and lipoprotein pattern with a fall in serum cholesterol and low density lipoprotein cholesterol and increase in high density lipoprotein cholesterol. Parenteral administration of 17-beta-oestradiol results in plasma concentrations of oestradiol corresponding to those in fertile women. Parenteral administration may take the form of: 20-100 mg oestradiol "pills" implanted subcutaneously, percutaneous administration of 0.05-0.1 mg oestradiol-containing capsules stuck to the skin every 24 hours, 3 mg daily or every second day in a water-alcohol gel, vaginally in cream, suppositories of impregnated vaginal synthetic material (Silastic) rings in daily doses of 0.5-0.25 mg. Percutaneous administration in gel from and partially with vaginal administration in cream or suppositories result in not inconsiderable diurnal variation and inter-individual variation in the plasma oestradiol concentrations obtained. In all of the cases, a relationship is found between the oestradiol and oestrone concentrations which are greater than or equal to one. Implantation treatment is associated with a considerable risk of overtreatment on account of increasing plasma oestradiol concentrations on repeated implantations.(ABSTRACT TRUNCATED AT 250 WORDS)