Lewis John G, McGill Helen, Patton Vivienne M, Elder Peter A
Steroid and Immunobiochemistry Laboratory, Canterbury Health Laboratories, P.O. Box 151, Christchurch, New Zealand.
Maturitas. 2002 Jan 30;41(1):1-6. doi: 10.1016/s0378-5122(01)00250-x.
To determine the levels of progesterone in plasma, red cells and saliva as well as pregnanediol-3-glucuronide excretion in postmenopausal women using transdermal progesterone creams.
A double-blind placebo controlled study was carried out using 24 postmenopausal women. Creams (placebo, 20 or 40 mg progesterone/g) were applied twice daily for 3 weeks followed by 1 week without before a further 3-week treatment. Morning samples were collected at 0, 1, 3, 4, 7 and 8 weeks for analysis.
There were small increases in plasma progesterone levels and pregnanediol-3-glucuronide excretion compared to the placebo group and red cell progesterone levels never exceeded plasma levels during progesterone cream use. Saliva progesterone levels were very high and variable in the progesterone cream groups compared to the placebo group and presented a paradox to the usual relationship observed between plasma and saliva progesterone in premenopausal women.
The absorption of progesterone from transdermal creams is low and we caution against the use of saliva measurements to monitor progesterone absorption. The low systemic absorption of progesterone may not be due to peripheral conversion by 5 alpha-reductase(s). We also conclude that the low level of progesterone associated with red cells suggests they are not important in the delivery of progesterone to target tissues.
测定使用经皮孕酮乳膏的绝经后女性血浆、红细胞和唾液中的孕酮水平以及孕二醇 - 3 - 葡萄糖醛酸苷的排泄情况。
对24名绝经后女性进行了一项双盲安慰剂对照研究。每天两次涂抹乳膏（安慰剂、20或40毫克孕酮/克），持续3周，然后停药1周，之后再进行3周治疗。在第0、1、3、4、7和8周采集早晨样本进行分析。
与安慰剂组相比，血浆孕酮水平和孕二醇 - 3 - 葡萄糖醛酸苷排泄量有小幅增加，在使用孕酮乳膏期间，红细胞孕酮水平从未超过血浆水平。与安慰剂组相比，孕酮乳膏组的唾液孕酮水平非常高且变化不定，这与绝经前女性血浆和唾液孕酮之间通常观察到的关系相悖。
经皮乳膏中孕酮的吸收较低，我们提醒不要使用唾液测量来监测孕酮吸收。孕酮的全身吸收低可能不是由于5α - 还原酶的外周转化。我们还得出结论，与红细胞相关的孕酮水平较低表明它们在将孕酮输送到靶组织中并不重要。
