Transdermales Östradiol und Progesteron
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- 作者：Prof. Dr. med. Dr. rer. nat. Alfred O. Mueck
- 关键词：SchlüsselwörterTransdermales Östradiol ; Progesteron ; Bioidentische Hormone
- 刊名：Gynäkologische Endokrinologie
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：15
- 期：1
- 页码：65-72
- 全文大小：
- 刊物主题：Gynecology; Endocrinology; Reproductive Medicine;
- 出版者：Springer Medizin
- ISSN：1610-2908
- 卷排序：15
文摘
So-called bioidentical hormone therapy is intended to reduce risks that, for example, were observed under classical hormone replacement therapy (HRT) in the Women’s Health Initiative. But how should bioidentical HRT to be defined? Hormone therapy is administered in the form of estrogens and progestogens. Only substances that are formed by the human body are considered bioidentical. If one also assumes a relevant systemic effect and corresponding approval, the selection is limited to estradiol (E2) and progesterone. Particularly the transdermal application of E2 can be described as bioidentical for two reasons: first, E2 amounts are systemically delivered as they are secreted by the ovaries in women of reproductive age. Second, as with ovarian secretion, the hormone passes directly into the venous system. Equine estrogens are imprecisely defined mixtures with concentrations that vary strongly. They also contain steroids found only in horse urine, including androgens, progestogens, and corticoids. Thus, equine estrogens are not bioidentical. The effects are not predictable, so there are also no clear dose–response relationships. Each HRT, whether oral or transdermal, is effective at adequate dosage—differences exist in the risk profile. Bioidentical HRT, i.e. transdermal estradiol combined with progesterone, can reduce cardiovascular risks, especially the risk of venous thrombosis. It also has advantages in other diseases. Bioidentical HRT is associated with the lowest risk of breast cancer and is safe regarding the endometrium as long as progesterone is used in the correct dosage and duration and the endometrium is monitored.