Abstract
Objectives. To assess the effectiveness and tolerability of transdermal estrogen in
men with hot flushes after hormonal therapy for prostate cancer.
Methods. Twelve men with moderate to severe hot flushes were randomized to receive
either low-dose (0.05 mg) or high-dose (0.10 mg) estrogen patches applied twice weekly
for 4 weeks. After a 4-week washout period in which no treatment was given, each patient
received the alternative dose for 4 weeks. Treatment response was assessed by daily
logs and questionnaires completed every 4 weeks that included a visual analog assessment.
Serum luteinizing hormone, follicle-stimulating hormone, testosterone, and estradiol
levels were also measured every 4 weeks during the study.
Results. There was a significant reduction in the overall severity of the hot flushes
seen in patients with both the low and high-dose estrogen patch. A significant reduction
in the daily frequency of the hot flushes was seen with the high-dose patch only.
Overall, 10 (83%) of 12 men reported either mild, moderate, or major improvement in
symptoms with either the low or high-dose patch. Mild, painless breast swelling or
nipple tenderness was noted in 2 (17%) and 5 (42%) of 12 men treated with the low
and high-dose estrogen patch, respectively. FSH levels decreased significantly with
both the low and high-dose patch. Estradiol levels increased from 12.1 to 16.4 pg/mL
and 26.9 pg/mL with the low and high-dose patch, respectively. There was no significant
change in serum testosterone or luteinizing hormone levels.
Conclusions. Transdermal estrogen appears to be a promising, well-tolerated therapy
for men with hot flushes after endocrine treatment for prostate cancer. Further study
in larger groups of patients is necessary to assess the relative effectiveness and
morbidity of this treatment.
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Article info
Publication history
Accepted:
July 19,
1999
Received in revised form:
July 19,
1999
Received:
June 21,
1999
Footnotes
☆This study was supported in part by a grant from TAP Pharmaceuticals and in part by NIH grant M01-RR00055.
Identification
Copyright
© 2000 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
