폐경후 여성에서 경피적 에스트라디올 겔과 경구영 프로게스테론 주기적 병합요법의 임상적 유효성에 관한 연구 = Effect of Transdermal Estrogen Gel Combined with Oral Progestogen Replacement Therapy in Korean Postmenopausal Women

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Objectives: The purpose of our study was to evaluate the effects of transdermal 17β -estradiol gel combined with oral progestogen in terms of serum lipid, bone markers and bone mineral density in Korean postmenopausal women Subjects and methods: Nine healthy postmenopausal women were asked to volunteer for pharmacokinetic analysis of estradiol gel. Subjects received daily application of 1.5 ㎎ of estrogen gel in the morning. Peripheral venous samples were drawn at 0, 0.5, 1, 2, 4, 8, 24, 48, 72 hours after the daily gel application and serum E2 levels were analyzed. 41 postmenopausal women with intact uterus and no menstruation for more than 12 months were treated with 1.5 ㎎ of estradiol gel (day 1-25) sequentially combined with 2.5㎎ of medroxyprogesterone acetate (day 16-25) orally for 1 year. Results: Although one volunteer showed increment of serum E2 one hour after application of estrogen gel, pharmacokinetic study showed increase of serum E2 after 24 hours in the most volunteers. The mean serum E2 level at 72 hour after application was 59.6±58.8 pg/㎖. The acceptability of the combined treatment was 73.2%. Only 1 (3.3%) woman complained skin irritation during treatment. The combined estradiol gel and oral progestogen therapy significantly decreased serum cholesterol levels by 7.8%, LDL by 8.5%. Markers of bone turnover significantly decreased 3 months after treatment. The increase of the annual percent change in bone density was 4.8% at the lumbar spine and 4.4% at the femoral neck. Conclusion: The combined estradiol gel with oral progestogen therapy is acceptable and effective treatment in postmenopausal women.