Estrogen Patch / Pill

[Guest guest]

FYI - I encourage all DFW women to become a part of this research. I think you will find the 'patch' is best for BI women.

MM/ NSIF

Monday | June 25, 2001

Estrogen patch, pill square off Absorption of hormone through skin may help fight high blood pressure, Dallas scientist reports 06/25/2001 By SHERRY JACOBSON / The Dallas Morning News Women who consider taking estrogen after menopause face a profusion of conflicting evidence about its ability to stave off heart disease, Alzheimer's and other serious medical conditions. If that debate were not already complicated enough, some researchers are collecting a new body of evidence on how the effectiveness of estrogen depends on whether it comes from a pill or a patch.

Eventually, women may be asked to weigh the assorted health benefits of taking estrogen in pill form vs. using a patch to deliver the hormone more directly to the bloodstream.

"Taking estrogen by mouth is a very unnatural way for the body to receive hormones," says Dr. Wanpen Vongpatanasin, a Dallas researcher whose most recent study compared how well estrogen worked in pill form versus a skin patch for raising or lowering blood pressure in a dozen women.

Her study, published last week in the medical journal Circulation , suggests that skin patches may be superior to oral estrogen in lowering blood pressure, and nerve cell activity associated with blood pressure, in postmenopausal women.

In the study, a group of healthy women in their 50s, who had been menopausal for at least a year, randomly received oral estrogen, an estrogen skin patch and a placebo, each for eight-week periods. Researchers recorded their sympathetic nerve activity and ambulatory blood pressure using microelectrodes. The women's blood pressure also was recorded during a 24-hour period before and after each eight-week session.

Dr. Vongpatanasin, an assistant professor of medicine at the University of Texas Southwestern Medical Center at Dallas, said she found that wearing an estrogen patch seemed to cause a small but statistically significant decrease in blood pressure in the women. It also decreased associated nerve activity by 30 percent.

"This study may lead to an effective therapy to treat or prevent hypertension after menopause," she said.

Estrogen's potential health benefits have been scrutinized since the 1940s, when women began taking it in pill form. Premarin, which won government approval in 1942, was the most commonly prescribed drug in the United States in the 1990s.

"Premarin was the first, and all the observational [medical] data is based on Premarin," says Sheila G. West, assistant professor of behavioral health at Penn State University. Dr. West's own estrogen research, published in April in the American Journal of Obstetrics and Gynecology, has found little difference between the effect of pills vs. patches on a variety of cardiovascular measures.

Her study confirmed previous research efforts, which found that both the pill and the patch lowered blood pressure during periods of psychological stress.

But Dr. West urged that estrogen patches needed much more study before any conclusions could be drawn decisively on their possible benefits.

"The relatively recent introduction of the estrogen patch means that its long-term impact on the risk of coronary events in postmenopausal women is also unknown," Dr. West noted.

In Dr. Vongpatanasin's study, oral estrogen had little effect on blood pressure. She theorized that might be due to the way the hormone is broken down by the body when taken orally.

"The liver converts oral estrogen to less-active forms, which requires that women take a dose that is three to 10 times more than they would normally need," Dr. Vongpatanasin said.

Estrogen skin patches differ from the pill form in that they deliver the hormone through the skin, directly into the bloodstream. Bypassing the liver allows estrogen to remain in its most active form, she noted.

But that may not be enough to persuade U.S. women to use estrogen in patch form.

Although the patches are popular in Europe, fewer than 10 percent of postmenopausal Americans are opting for patch versions, which are available from several pharmaceutical companies. (Women who have not had a hysterectomy should supplement estrogen with progesterone in a pill or cream for at least 10 days a month in order to decrease the risk of uterine cancer.)

Dr. Vongpatanasin, 34, says she can sympathize with some of the complaints she's heard about the patch. Women in her study found that the patch sometimes fell off, requiring them to tape it to their lower backs, where it was to be worn for three and four days at a time.

"A few women found that the alcohol in the patch, which keeps the estrogen from seeping out, irritated their skin," the researcher said. "In my next study, we're using a patch that does not contain alcohol."

That estrogen study will involve a dozen postmenopausal women who have mild hypertension. She is hoping to see whether using an estrogen patch will reduce their symptoms, making it unnecessary for them to take additional medication.

Women interested in joining the six-month study may call 214-648-2968 to see whether they qualify to participate.

"We don't know if this will translate into improved longevity, reduced strokes and heart attacks," the doctor said of her estrogen studies. "Larger studies will be needed for that."

The American Heart Association and the American College of Cardiology are providing funding for her research.

Martha Murdock, DirectorNational Silicone Implant FoundationDallas, Texas Headquarters

Purposes for which the Corporation (NSIF) is organized are to perform the charitable activities within the meaning of Internal Revenue Code Section 501©(3) and Texas Tax Code Section 11.18 ©(1).Specifically, the Corporation is organized for the purposes of education and research of Ilicone-related disease.

Attachment: vcard [not shown]