[Percutaneous estrogen therapy in the post-menopausal period].

Percutaneous application of estradiol in the postmenopause is considered to be a promising alternative to oral estrogen replacement therapy. Since it avoids the first liver passage, the resulting circulatory hormone patterns seem to be more physiological and the dose can be greatly reduced. The efficacy and some of the pharmacological effects of a newly developed hydroalcoholic gel containing 17 beta-estradiol were investigated in 114 postmenopausal women. Within 3 months the Kuppermann index, which scores 11 of the most important climacteric symptoms, dropped from 29.0 to 6.9 and from 29.0 to 9.3 points in ovariectomized patients. Vaginal atrophy was greatly improved, the maturation index increased from 2/31/66 to 29/54/12. The body weight and the blood pressure were not significantly influenced, total cholesterol, triglycerides, and LDL- and VLD-cholesterol decreased, while HDL-cholesterol remained unchanged. Local and systemic side effects were relatively rare: 6.1% of all women complained of breast tenderness and 2.6% recorded vaginal bleedings. The acceptability of the topical treatment was excellent. Since recent studies have shown effective prevention of postmenopausal bone loss, the gel could become an attractive method in clinical practice.