Different Delivery Systems Of Estrogens Discussion

Different Delivery Systems Of Estrogens Discussion

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Different Delivery Systems of Estrogens;
Thank you, for your discussion on this topic.
There are many dosage forms and different delivery systems of estrogen. You and your peers have throughly discussed the risks associated with the use of hormone replacement therapy in women with a history of breast cancer. I do have a quick question– could you list over delivery systems of estrogens that are available –and do all delivery systems including but not limited to transdermal and topical pose the same associated risk as the oral delivery method and are their risks age specific?

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Various delivery systems for oestrogen include oral tablets, transdermal topical (non-patch) products, transdermal patches, injectables, and intravaginal preparations. Nonetheless, the oral tablet is the most common route of oestrogen administration in various countries, including the US (Levin et al., 2018)Different Delivery Systems Of Estrogens Discussion.

The oral delivery method poses a higher risk than other administration routes, such as transdermal and topical pose. Administering estrogen orally exposes individuals to undesirable physiologic effects from hepatic and gut metabolism. According to Mehta et al. (2021), liver metabolism triggers an overproduction of coagulation factors and different inflammatory markers and an increased risk of gallstones and venous thromboembolism (VTE). On the contrary, some adverse drug effects are mitigated in transdermal drug delivery by eliminating hepatic and gut first-pass metabolism. Studies show that transdermal delivery can administer estradiol to the bloodstream directly without metabolizing it (Mehta et al., 2021). Additionally, transdermal delivery administers lower estrogen doses than oral products, limiting hepatic protein production stimulation. Therefore, various estradiol transdermal delivery technologies, including patches, transdermal spray, and topical gels, are recommended over oral delivery to minimize potential drug-related adverse effects.

Risk in all delivery systems, including oral, transdermal, and topical, increases with age. Studies show that the risk of estrogen is low in healthy women aged 60 or those aged 5 to 10 years post menopause (Manson et al., 2020)Different Delivery Systems Of Estrogens Discussion.

References

Levin, V. A., Jiang, X., & Kagan, R. (2018). Estrogen therapy for osteoporosis in the modern era. Osteoporosis International, pp. 29, 1049–1055.

Manson, J. E., Bassuk, S. S., Kaunitz, A. M., & Pinkerton, J. V. (2020). The Women’s Health Initiative trials of menopausal hormone therapy: lessons learned. Menopause, 27(8), 918-928.

Mehta, J., Kling, J. M., & Manson, J. E. (2021). Risks, benefits, and treatment modalities of menopausal hormone therapy: Current concepts. Frontiers in endocrinology, p. 12, 564781 Different Delivery Systems Of Estrogens Discussion