Estrogen replacement therapy in postmenopausal women: a
study of the efficacy of estriol and changes in plasma
gonadotropin levels
T. Ushiroyama A1, M. Sakai A2, T.
Higashiyama A3, A. Ikeda A4, M. Ueki
A5
A1 Department of Obstetrics and Gynecology,
Osaka Medical College, Takatsuki,
Japan
A2 Department of Obstetrics and
Gynecology, Osaka Medical College, Takatsuki,
Japan
A3 Department of Obstetrics and
Gynecology, Osaka Medical College, Takatsuki,
Japan
A4 Department of Obstetrics and
Gynecology, Osaka Medical College, Takatsuki,
Japan
A5 Department of Obstetrics and
Gynecology, Osaka Medical College, Takatsuki, Japan
Abstract:
The purpose of this study was to clarify the efficacy of
estriol for estrogen replacement therapy in postmenopausal
women with undefined symptoms and to evaluate endocrinological
changes during therapy in relation to clinical outcome.
Administration of 2 mg estriol in 168 postmenopausal patients
was markedly effective in 22.6% of cases, effective in 45.2%,
fairly effective in 14.3%, and ineffective in 17.9% of cases.
The plasma concentration of follicle-stimulating hormone (FSH)
and luteinizing hormone (LH) after administration of estriol
decreased significantly (p < 0.001), by 52.2% and
32.9%, respectively for markedly effective cases, and by 39.1%
and 48.0% for effective cases. In contrast, the plasma
estradiol concentration remained unchanged. On the other hand,
decreases in FSH and LH concentration were 13.9% and 5.9% for
the fairly effective and 8.2% and 1.9% for ineffective cases,
demonstrating a significantly lower decrease in plasma FSH and
LH levels than in the markedly effective and effective cases
(p < 0.001). For cases showing side-effects, the
plasma FSH and LH levels decreased by 52.0% and 64.3%,
respectively, whereas the plasma estradiol level remained
unchanged.
In conclusion, the efficacy of estriol was
significantly correlated to the degree of decrease in plasma
FSH and LH levels in patients with undefined symptoms. In
addition, efficacy appeared to be correlated to the incidence
of side-effects. The degree of reduction of FSH (39.1-52.2%)
and LH (48.0-64.3%) from the baseline may possibly be used as
a guide to the therapeutic hormone levels during HRT. The
present results suggest that plasma gonadotropin levels could
be a useful indicator in the management of patients undergoing
estrogen replacement therapy.
Keywords:
Estriol, Hrt, Postmenopause, Endocrine Changes
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