Low-dose transdermal estradiol for symptomatic perimenopause

In Brief Objective To determine whether low-dose transdermal estrogen therapy is associated with a reduction in vasomotor symptoms in women who continue to have menstrual cycles. Design An open-label, observational evaluation conducted over 12 months in 22 consecutive perimenopausal women with vasomotor symptoms. Results Improvement in vasomotor symptoms was reported by 16 (73%) of women evaluated. Of responders, 11 characterized symptom relief as complete and 6 as moderate. Fifteen (68%) of the women remained on transdermal estrogen at 12 months. No adverse health-related events were attributed to estrogen therapy. Conclusion Low-dose transdermal estrogen is well tolerated and was associated with a reduction in complaints of vasomotor symptoms before menopause. The steady-state pharmacokinetics of transdermal delivery of unopposed estrogen may be advantageous in a population sensitive to fluctuations in circulating hormone levels. Vasomotor symptoms after menopause can be reversed with exogenously administered estrogens. This observational study evaluated whether transdermal estradiol is associated with similar protection against vasomotor symptoms in perimenopausal women.