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Does the route of administration of hormones make a difference?
Most of the data on the long-term health effects of hormones come from studies where hormones (estrogen alone or estrogen in combination with progesterone or progestin) are administered orally in the form of pills. Other ways hormones are given include transdermal patches, gels, and vaginal creams and rings. These forms of estrogen are all equally effective methods of treating symptoms of menopause, such as hot flashes and vaginal dryness. In addition, progesterone is available as a pill or gel.
Several studies have found that the benefit of transdermal products on bone density and bone metabolism is comparable to that of oral therapy (39, 40, 41). It is not known whether transdermal
estrogen and progestin will have different effects than pills on the heart and blood vessels.
The amount of estrogen that enters the bloodstream from estrogen-containing vaginal creams and rings depends on the types of hormones and the dose. Generally, vaginal administration of hormones results in lower levels of circulating hormones compared with an equivalent oral dose. Because the vaginal epithelium (thin layer of tissue that covers the vagina) responds to very small doses of estrogen, low-dose estrogen-containing creams can be used to correct some effects of menopause on the vagina. Vaginal estrogen therapy does not appear to protect against bone loss (39,
40).
Questions and
Answers About Menopausal Hormone Use
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