Postmenopausal oestrogen replacement therapy with subcutaneous oestradiol implants

Abstract

Ten postmenopausal patients were treated by means of subcutaneous oestradiol-releasing silastic implants. Half of the patients received 3 implants, each containing 12 mg oestradiol valerate (E2V), while the other half received 4 implants, each containing 27 mg oestradiol benzoate (E2B). Progestogen was added to the treatment for 14 days, 6 weeks after implant insertion and every fourth week thereafter. Serum levels of oestrone (E1), oestradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were followed up. The effects on endometrial thickness, uterine volume and breast tissue were evaluated by ultrasound, mammography also being used for breast examination. The follow-up period was 24 weeks, but the implants were not removed until the climacteric symptoms reappeared. E1 and E2 levels remained higher and gonadotrophin levels lower than the pretreatment values during the 24-week follow-up period. Oestrogen effects were seen in both the uterus and the breasts. Both types of implant were effective in relieving climacteric symptoms. The mean time for symptom return was 10 months (range 6-18 months) in the E2V group and 8 months (range 4-12 months) in the E2B group. Our results indicate that nonbiodegradable controlled-release oestrogen implants offer a safe, effective, convenient and well-accepted alternative means of administering oestrogen replacement therapy.