An oestrone-releasing vaginal ring in the treatment of climacteric women

Abstract

Post-menopausal patients were treated with a new form of oestrogen administration by using two types of oestrone-containing vaginal rings. It was observed that oestrone was absorbed from the vagina as demonstrated by elevated plasma concentrations of oestrone (E 1) and oestradiol (E 2). In 3 out of 4 patients the ratio of E 1/E 2 was 4–5 in the first plasma samples collected after the initiation of the treatment. After the first week of treatment this ratio had dropped to 0.8–1.5, which indicates an increase and stabilization in the conversion of oestrone to oestradiol within 1 wk of treatment. The high levels of plasma oestrogens were associated with a decrease of plasma gonadotrophins and the disappearance of climacteric symptoms. The first type of ring tested resulted in a high initial burst of oestrone release, as evidenced by high concentrations of oestrone and oestradiol during the first 2 wk. In the second type of vaginal ring the high initial oestrone release was not present and the plasma oestrone and oestradiol levels were stable. The patients tolerated the treatment well, and after gaining experience, easily accepted this route of self-administration. It seems that the vaginal silastic ring is an effective steroid-delivery system in post-menopausal women. As judged by plasma oestrone and oestradiol profiles, it seems that the second type of ring was preferable to the first one as an intravaginal releasing device.