THROMBOPHILIA AND LIPID PROFILE IN POSTMENOPAUSAL WOMEN USING A NEW TRANSDERMAL ESTRADIOL PATCH

Objective: To assess the changes, over a 6-month period, in serum lipo proteins, apoproteins and coagulation factors, induced in post-menopau sal women treated by a new transdermal oestradiol patch. Methods: Fift y-three hysterectomised, healthy, postmenopausal women were treated by a new transdermal patch designed to deliver 50 Bg of 17 beta oestradi ol per day (Gynaderm, Shire Developments). One patch was applied twice weekly. Results: Forty-two patients completed the study. There was no significant change in the level of total cholesterol, triglycerides, HDL, or LDL. There was a significant rise in the level of ApoAI after 3 months on therapy but this was not sustained after 6 months; there w as also a significant drop in the level of ApoAII after 6 months on tr eatment. The changes in ApoB and Lp(a) were not statistically signific ant. There was a significant drop in the level of antithrombin III and of protein S, and a significant rise in factor VII. The drop in the l evel of fibrinogen and of protein C were not statistically significant . Conclusion: The transdermal route of oestradiol administration cause s minimal changes in lipoprotein metabolism. The statistically signifi cant changes in the thrombophilia profile parallel those observed with oral HRT, but, similarly, may not reflect clinical significance. The potential of transdermal oestrogens as cardioprotective agents is yet to be determined.