Corson S L
Philadelphia Fertility Institute Section Head, Reproductive Endocrinology, Pennsylvania Hospital.
Int J Fertil. 1993 Mar-Apr;38(2):79-91.
Although estrogen replacement therapy (ERT) has proven highly effective in preventing both the short- and long-term adverse clinical outcomes associated with menopause, it is important to recognize that the pharmacokinetic and metabolic effects of ERT vary with dosage and route of delivery. One of the most promising methods of administering ERT is the transdermal therapeutic system (TTS), or "patch," the efficacy of which is comparable to that of other forms of ERT, but whose unique pharmacokinetic profile may confer several distinct clinical advantages over the oral route. The present article addresses some of the key pharmacokinetic and metabolic differences between these two dosing forms, with particular emphasis on their respective effects on gonadotropins, hemostasis and coagulation, lipid metabolism, hepatobiliary function, and bone. An extensive review of clinical experience accrued over the past decade suggests that transdermal ERT is a viable alternative to oral ERT.
尽管雌激素替代疗法（ERT）已被证明在预防与更年期相关的短期和长期不良临床后果方面非常有效，但必须认识到ERT的药代动力学和代谢效应会因剂量和给药途径而异。最有前景的ERT给药方法之一是经皮治疗系统（TTS），即“贴片”，其疗效与其他形式的ERT相当，但其独特的药代动力学特征可能比口服途径具有几个明显的临床优势。本文阐述了这两种给药形式之间的一些关键药代动力学和代谢差异，特别强调了它们对促性腺激素、止血和凝血、脂质代谢、肝胆功能及骨骼的各自影响。对过去十年积累的临床经验进行的广泛综述表明，经皮ERT是口服ERT的可行替代方案。
