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P291 A retrospective assessment of sixteen years experience with oestrogel in three specialist menopause clinics
P291
P291 (cant)
A RETROSPECTIVE ASSESSMENT OF SIXTEEN YEARS EXPERIENCE WITH OESTROGEL IN THREE SPECIALIST MENOPAUSE CLINICS NJ Colville, KE Morris, D Ross, VA Godfiee, AJ Cooper, CP Soencer. MI Whitehead. King’s College Hospital, London, SE5 9RS, Amarant Centre, London, SE1 7PW, Queen Charlotte’s & Chelsea Hospital, London, W6 OXG. UK. Oestrogel” (Hoechst Marion Roussel, Denham, UK) is a 175oestradiol gel for cutaneous application. Widely used by postmenopausal women in France, it has only recently been licensed in the UK, but was previously used on a named-patient basis by specialist centres. We report the results of a case records review of these patients. Analysis has so far been performed on 75 cases. The cohort has a mean f SD age of 57.4 f 8.8 years and a mean f SD age at LMP or onset of climacteric symptoms of 45.4 f 7.1 years. Forty-three (57%) had had a premenopausal hysterectomy (H), of whom 15 (20% of total) had also had a premenopausal BSO (H+BSO). Age at menopause was lowest in the H+BSO group (41.7 f 8.8); age at onset of climacteric symptoms was significantly lower in hysterectomised, non-oophorectomised women than in women with an intact uterus (44.3 f 6.9 vs. 48.2 f 5.3, p=O.O2), confirming previous reports of the effect of hysterectomy.
Oestrogel@ was the first HRT used by 24 women (34%). Among those who had switched from other therapies, 41 (80%) had previously used oral preparations, 36 (71%) transdermal patches and 13 (25%) implants. Reasons given for stopping these therapies included poor symptom relief in 35 (69%), skin irritation or poor patch adhesion in 19 (37%), other side effects in 15 (29%) and implant tachyphylaxis in 10 (20%). At their last visit 59 women (79%) were still using Oestrogel’? the mean duration of use was 7.1 f 5.4 years. Women who stopped Oestrogel@ had used it for a mean of 5.9 f 5.3 years. Reasons for stopping Oestrogel@ were: poor symptom relief (3) messy to use (3) side effects (3), switched to a no-bleed treatment (3) and other (4). Mean f SD plasma oestradiol in women using 5 g/d Oestrogel@ (3 mg/d 175-oestradiol) was 349 f 204 pmol/l.
Continued
P292
P293
PERCUTANEOUS MICRONIZED PROGESTERONE PHARMACOCINETIC C. Valls-Llobet *, G.Borrds *, M. Fuentes * *, T.Bd[ckstriim, * ** *Women’s Health and Quality of Life Prog. CAPS, Autonomous University of Barcelona, **Catalan Institute of Health (ICS), ***Umea University HRT Hormonal replacement therapy in the next future has to be easily applied, the most similar to natural hormones and its metabolites for the body. Natural progesterone may better compensate mitotic effect of estrogens for hormonal replacement therapy in menopause. Natural progesterone may easily produce its own metabolites after administration for women’s bodies by percutaneous way because skin contents 5 CI reductase. To study the human pharmacocinetics natural progesterone after percutaneous of micronized administration. Eight women, 49-55 years old, with a year of menopause but without any hormonal treatment for the last 6 months no endocrinological or psychological diseases were asked to apply one dose of 20gr of progesterone percutaneously (jelly 1%) , blood samples were drawn 1 hour before therapy and at 1, 2, 6, 12, 24 and 36 hours after treatment. Serum levels were analysed by RIA. Micronized natural progesterone is absorved percutaneously showing circulating progesterone levels 12 to 24 hours after single dose application. Progesterone serum levels had an increase at 12 hours postadministration 8+/-nmol/l (mean+/-SD) . Levels were high till 24 hours after only one dose of treatment.
207
DIFFERENCES IN LIPIDS AND BLEEDING PATTERNS BETWEEN 2 TYPES OF HORMONAL REPLACEMENT THERAPY = A SEQUENTIAL VERSUS A CONTINUOUS COMBINED HORMONAL REPLACEMENT. m YK Chin, BC Lim, ML Sim, O&G Department, Singapore General Hospital, Outram Road, Singapore 169608. 2 groups of Singaporean postmenopausal‘ women completed one year of hormonal replacement therapy (HRT): a sequential HRT (S) of daily premarin and cyclical provera of 14 days (n=l9) and a continuous combined HRT (C) of daily estradiol and NETA (n=23). Analysis of serum lipids at the end of one year showed that both treatments resulted in similar decreases in total cholesterol and LDL cholesterol. However, significant differences were seen in HDL cholesterol and triglycerides. The S regime raised HDL (8%) and triglycerides (35%). The C regime depressed HDL (6%) and triglycerides (11%). S regime resulted in cyclical bleeding commonly between Days 1- 19 and 22-28. However 23% of cycles were amenorrhoeic. Abnormal bleeding occurred in 8% of cycles but none had abnormal pipelleendometrial findings. C regime resulted in complete amenorrhoea in only 8% of patients (2/23). At the end of a year, 34% (S/23) achieved amenorrhoea Spotting was the main type of bleeding, with a mean of 41 days. Analysis of these difference in response to the regimes may help clinicians select and tailor different combinations of HRT to individual needs.
P291 (cant)
A RETROSPECTIVE ASSESSMENT OF SIXTEEN YEARS EXPERIENCE WITH OESTROGEL IN THREE SPECIALIST MENOPAUSE CLINICS NJ Colville, KE Morris, D Ross, VA Godfiee, AJ Cooper, CP Soencer. MI Whitehead. King’s College Hospital, London, SE5 9RS, Amarant Centre, London, SE1 7PW, Queen Charlotte’s & Chelsea Hospital, London, W6 OXG. UK. Oestrogel” (Hoechst Marion Roussel, Denham, UK) is a 175oestradiol gel for cutaneous application. Widely used by postmenopausal women in France, it has only recently been licensed in the UK, but was previously used on a named-patient basis by specialist centres. We report the results of a case records review of these patients. Analysis has so far been performed on 75 cases. The cohort has a mean f SD age of 57.4 f 8.8 years and a mean f SD age at LMP or onset of climacteric symptoms of 45.4 f 7.1 years. Forty-three (57%) had had a premenopausal hysterectomy (H), of whom 15 (20% of total) had also had a premenopausal BSO (H+BSO). Age at menopause was lowest in the H+BSO group (41.7 f 8.8); age at onset of climacteric symptoms was significantly lower in hysterectomised, non-oophorectomised women than in women with an intact uterus (44.3 f 6.9 vs. 48.2 f 5.3, p=O.O2), confirming previous reports of the effect of hysterectomy.
Oestrogel@ was the first HRT used by 24 women (34%). Among those who had switched from other therapies, 41 (80%) had previously used oral preparations, 36 (71%) transdermal patches and 13 (25%) implants. Reasons given for stopping these therapies included poor symptom relief in 35 (69%), skin irritation or poor patch adhesion in 19 (37%), other side effects in 15 (29%) and implant tachyphylaxis in 10 (20%). At their last visit 59 women (79%) were still using Oestrogel’? the mean duration of use was 7.1 f 5.4 years. Women who stopped Oestrogel@ had used it for a mean of 5.9 f 5.3 years. Reasons for stopping Oestrogel@ were: poor symptom relief (3) messy to use (3) side effects (3), switched to a no-bleed treatment (3) and other (4). Mean f SD plasma oestradiol in women using 5 g/d Oestrogel@ (3 mg/d 175-oestradiol) was 349 f 204 pmol/l.
Continued
P292
P293
PERCUTANEOUS MICRONIZED PROGESTERONE PHARMACOCINETIC C. Valls-Llobet *, G.Borrds *, M. Fuentes * *, T.Bd[ckstriim, * ** *Women’s Health and Quality of Life Prog. CAPS, Autonomous University of Barcelona, **Catalan Institute of Health (ICS), ***Umea University HRT Hormonal replacement therapy in the next future has to be easily applied, the most similar to natural hormones and its metabolites for the body. Natural progesterone may better compensate mitotic effect of estrogens for hormonal replacement therapy in menopause. Natural progesterone may easily produce its own metabolites after administration for women’s bodies by percutaneous way because skin contents 5 CI reductase. To study the human pharmacocinetics natural progesterone after percutaneous of micronized administration. Eight women, 49-55 years old, with a year of menopause but without any hormonal treatment for the last 6 months no endocrinological or psychological diseases were asked to apply one dose of 20gr of progesterone percutaneously (jelly 1%) , blood samples were drawn 1 hour before therapy and at 1, 2, 6, 12, 24 and 36 hours after treatment. Serum levels were analysed by RIA. Micronized natural progesterone is absorved percutaneously showing circulating progesterone levels 12 to 24 hours after single dose application. Progesterone serum levels had an increase at 12 hours postadministration 8+/-nmol/l (mean+/-SD) . Levels were high till 24 hours after only one dose of treatment.
207
DIFFERENCES IN LIPIDS AND BLEEDING PATTERNS BETWEEN 2 TYPES OF HORMONAL REPLACEMENT THERAPY = A SEQUENTIAL VERSUS A CONTINUOUS COMBINED HORMONAL REPLACEMENT. m YK Chin, BC Lim, ML Sim, O&G Department, Singapore General Hospital, Outram Road, Singapore 169608. 2 groups of Singaporean postmenopausal‘ women completed one year of hormonal replacement therapy (HRT): a sequential HRT (S) of daily premarin and cyclical provera of 14 days (n=l9) and a continuous combined HRT (C) of daily estradiol and NETA (n=23). Analysis of serum lipids at the end of one year showed that both treatments resulted in similar decreases in total cholesterol and LDL cholesterol. However, significant differences were seen in HDL cholesterol and triglycerides. The S regime raised HDL (8%) and triglycerides (35%). The C regime depressed HDL (6%) and triglycerides (11%). S regime resulted in cyclical bleeding commonly between Days 1- 19 and 22-28. However 23% of cycles were amenorrhoeic. Abnormal bleeding occurred in 8% of cycles but none had abnormal pipelleendometrial findings. C regime resulted in complete amenorrhoea in only 8% of patients (2/23). At the end of a year, 34% (S/23) achieved amenorrhoea Spotting was the main type of bleeding, with a mean of 41 days. Analysis of these difference in response to the regimes may help clinicians select and tailor different combinations of HRT to individual needs.