Oestrogen-based therapies for menopausal symptoms

• Published in: Baillière's best practice & research. Clinical endocrinology & metabolism Vol. 38; no. 1; p. 101789
• Main Authors: Laing, Abbie, Hillard, Tim
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-01-2024
• Subjects: Estrogens - therapeutic use; Female; Hormone Replacement Therapy; Humans; Menopause; oestrogen-based therapies; oral oestrogen; risks and benefits; transdermal oestrogen; vaginal oestrogen; oestrogen-based therapies; risks and benefits; oral oestrogen; vaginal oestrogen; transdermal oestrogen
• ISSN: 1521-690X; 1878-1594
• DOI: 10.1016/j.beem.2023.101789

To summarise the dosing options, regimens, pharmacokinetics, risks and benefits of oestrogen-based therapies for the treatment of menopausal symptoms.
A review of the literature was undertaken using multiple databases. Randomised trials, observational studies, meta-analyses and review papers were included.
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.
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.