Effects of Various Estrogenic Preparations: IV. Alpha-Estradiol Administered Intraorally in a Polyethylene Glycol Wax: Objective and Subjective Effects in Climacteric Women

Abstract

Abstract 1.1. Forty-one women were treated with one or more injections of equivalent amounts of seven estrogenic preparations to a total of 57 tests. In thirty-nine tests, changes occurred in the vaginal mucosa; of these, however, seven were difficult to evaluate in relation to the administration of the estrogen. No objective response followed any of the remaining eighteen injections. 2.2. Free estrone, free estradiol, and the benzoic acid and dipropionic acid esters of the latter were the estrogens employed in these tests. Estrone was given in doses of 4 mg. and each estradiol preparation in amounts of 1 mg. per injection. Estrone was used as an equeous suspension only. Free estradiol was similarly employed, and also as a solution in propylene glycol and sesame oil, respectively. Estradiol dipropionate was prepared as a solution in sesame oil only; the benzoate was administered in menstrua of peanut oil and propylene glycol, respectively. 3.3. Daily vaginal smears were taken for a control period of approximately one week prior to therapy and for an average period of ten days thereafter. Approximately 900 smears were studied. 4.4. The average lag-time (hours between injection and vaginal response) for each preparation was as follows: estradiol dipropionate in sesame oil, 88; estradiol benzoate in peanut oil, 90; estradiol in aqueous suspension, 90; estrone in aqueous suspension, 100; estradiol in sesame oil, 108; estradiol in propylene glycol, 114; and estradiol benzoate in propylene glycol (one case), 120. 5.5. The average duration in hours of the vaginal response initiated by estradiol dipropionate in sesame oil was 100; by estradiol benzoate in peanut oil, 82; by estradiol in sesame oil, 36; by estradiol in propylene glycol, 120; by estradiol in aqueous suspension, 109; and by estrone in aqueous suspension, 110. 6.6. The degree of follicular activity varied widely with the preparation used and from subject to subject, but in any given instance, was directly proportional to the duration of the vaginal changes. 7.7. Climacteric patients reported symptomatic relief starting one to three days following injection and persisting for from three to ten days thereafter.