SALMON-CALCITONIN PLUS INTRAVAGINAL ESTRIOL - AN EFFECTIVE TREATMENT FOR THE MENOPAUSE

Objective: Intravaginal estriol (E3) effectively improves postmenopaus al genito-urinary disturbances, without stimulating endometrial prolif eration. The aim of the present study was to evaluate the effect of in travaginal estriol (E3) plus nasal spray salmon calcitonin (sCT), to i mprove neurovegetative symptoms and to prevent the decline of bone min eral density (BMD) of postmenopausal women. Methods: Two hundred and f ourteen (214) healthy postmenopausal women were treated for 12 months with: (1) E3 (0.5 mg every other day) + Ca (0.5 g/day); (2) E3 + Ca sCT (50 IU x 2/day); (3) sCT + Ca; (4) Ca. Climacteric complaints, suc h as hot flushes and sweating, BMD at the distal 1/10 of the radius, a nalyzed by dual photon absorptiometry, urinary excretion of hydroxypro line and serum alkaline phosphatase were evaluated at baseline and eve ry 6 months. At the same time, patient compliance and drug tolerabilit y were evaluated. Results: E3 but not sCT, improved hot flushes and sw eating. E3 blunted but not completely counteracted the BMD decline obs erved in women treated with only Ca, and reduced urinary hydroxyprolin e excretion. sCT markedly increased BMD Values and reduced both urinar y hydroxyproline excretion and serum alkaline phosphatase. These effec ts were not potentiated by E3 coadministration. All treatments were we ll tolerated. Conclusions: Present data indicate that the combined adm inistration of intravaginal E3 and sCT may represent an alternative th erapeutic regimen for those postmenopausal women who do not accept or have contraindications to classical hormone replacement therapy.