A comparison of 25 mg and 50 mg oestradiol implants in the control of climacteric symptoms following hysterectomy and bilateral salpingo-oophorectomy

Objectives 1. To compare the effects of 25 mg and 50 mg oestradiol implants on serum follicle stimulating hormone and oestradiol levels; and 2. to ass ess the relationship of the dose of oestradiol implant and serum oestradiol on the effectiveness and duration of climacteric symptom control. Design Randomised,double-blind investigation. Participants Forty-four women, who had undergone total abdominal hysterecto my and bilateral salpingo-oophorectomy. Methods The women were randomised to receive either 25 mg (n = 20) or 50 mg (n = 24) oestradiol implants. Follow up consisted of prospective symptom e nquiry and hormone assays. Main outcome measures Primary: climacteric symptom control: duration and ef fectiveness; secondary: serum oestradiol and follicle stimulating hormone l evels Results Serum oestradiol was significantly higher and serum follicle stimul ating hormone significantly lower after the fourth month of treatment in wo men receiving 50 mg implants. No significant difference in symptom control was noted in the two groups. The mean duration of symptom control was simil ar in the two groups: 5.9 months (SD 2.4) in those receiving 50 mg oestradi ol and 5.6 months (SD 2.3) in those receiving 25 mg. Conclusion The higher level, 50 mg oestradiol implants does not result in b etter control of symptoms nor in longer periods of symptom control compared with 25 mg oestradiol implants. In order to maximise compliance, 25 mg oes tradiol implants should therefore be the treatment of choice for women with normal bone density seeking relief of climacteric symptoms.