[Transdermal estradiol in the prevention of the menopause-induced increase in osteoresorption].

: In the introduction of the paper the authors explain that it is essential to adopt effective preventive provisions to prevent the loss of osseous tissue in women after the menopause and to prevent osteoporotic fractures. In Bohemia and Moravia during the last 20 years the incidence of these frequently fatal or invalidating fractures of the proximal femur has increased substantially and in view of the ageing of the population it may be assumed that this trend will proceed further. Among possible preventive provisions, in order to eliminate undesirable metabolic side-effects of long-term hormonal substitution treatment, it seems best to administer by the parenteral route natural oestradiol by using the transdermal therapeutic Estraderm TTS system. Its effectiveness in suppressing menopause-induced enhanced bone resorption was tested in 11 women where on average within three months after bilateral ovariectomy increased bone resorption was found. In all women in the course of four months treatment all biochemical indicators of bone remodelling became normal - urinary excretion of hydroxyproline, acid plasma phosphatase activity, serum alkaline phosphatase isoenzyme, and serum osteocalcin. The dynamics of indicators of osteoresorption were similar as in women treated with oral synthetic oestrogen, which may produce, however, serious metabolic side-effects. Substitution treatment with Estraderm improves significantly also other manifestations of the climacteric oestrogen deficiency syndrome. Its safety is further enhanced by combination with progesterone.