Oestrogen-based therapies for menopausal symptoms

Abstract

Purpose: To summarise the dosing options, regimens, pharmacokinetics, risks and benefits of oestrogen-based therapies for the treatment of menopausal symptoms.

Methods: A review of the literature was undertaken using multiple databases. Randomised trials, observational studies, meta-analyses and review papers were included.

Results: Multiple systemic preparations of oestrogen exist and all appear comparable in terms of efficacy. They differ by pharmacokinetics and those preparations that avoid hepatic metabolism have a lower risk profile in general although their use can be limited by skin barriers or patient acceptability. All vaginal oestrogen treatments are comparable in efficacy and have not been associated with any health risks. Side-effects between all preparations differ.

Conclusions: With regards to oestrogen treatments there is not a one size fits all. Multiple treatments are available and a clinician's role is to guide and help women make evidence based, unbiased and informed choices.

Keywords: oestrogen-based therapies; oral oestrogen; risks and benefits; transdermal oestrogen; vaginal oestrogen.