Serum Estradiol and Follicle-Stimulating Hormone Levels in Thai Women Post Total Abdominal Hyste- rectomy and Bilateral Oophorectomy Using Oral 17 Estradiol
SUVIT BUNYA VEJCHEVIN, M.D., M.H.S. *, CHAREONCHAI PANTHONG, M.D.*.*, KHUNYING KOBCHITT LIMPAPHAYOM, M.D.*
Affiliation : *Department of Obstetrics & Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ** Maternal and Child Hospital, Health Promotion Center 8, Nakhon Sawan 60000, Thailand.
Objective : To assess the difference of serum estradiol (E ) and follicle stimulating hor 2 mone (FSH) levels in Thai women post total abdominal hysterectomy and bilateral oophorectomy, before and after using a daily dose of 2 mg oral 17 P-estradiol. Study
Design : Experimental study (before and after treatment).
Setting : Menopause Clinic, Department of Obstetrics and Gynecology, Faculty of Medi cine, Chulalongkom University.
Subjects : Thirty-five women who had undergone total abdominal hysterectomy and bilateral oophorectomy at Chulalongkom Hospital 1 week previously due to benign gynecologic conditions were recruited in the study. Body mass index was 20-25 kg/m2 * These women had no contraindication for using hormonal replacement therapy and no history of any hormonal intake in the past.
Intervention : All subjects were assigned to receive a daily dose of 2 mg oral 17 P-estra diol applied at bedtime (8.00 p.m.).
Main outcome measures : Serum E and FSH were measured before and after the study 2 at weeks 4, 8 and 12, 12-14 hours after oral application. The hormonal measurement was performed using the time-resolved fluoroimmunoassay (FIA) method.
Results : Five cases were excluded, three cases due to poor compliance which was less than 85 per cent and two cases due to loss to follow-up. Of the remaining 30 cases, the mean age and body mass index were 43.03 ± 4.58 years and 22.72 ± 1.86 kg/m2 , respectively. Serum E 2 level significantly increased from baseline value at 4, 8 and 12 weeks (median of E value at 0, 2 4, 8 and 12 weeks : 20.00, 22.50, 324.65 and 355.35 pmol/L, p<0.001). On the other hand, there was no significant difference in the FSH serum level (median of FSH value at 0, 4, 8 and 12 weeks : 18.65, 18.40, 18.60 and 20.35 lUlL, p=0.517).
Conclusion : A daily dose of 2 mg oral 17 ~-estradiol taken at bedtime (8.00 p.m.) for 12 weeks increased the serum E to the follicular phase level of the normal menstrual cycle. On the 2 other hand, there was no significant difference in the FSH serum level.
Keywords : Estradiol, Follicle-Stimulating Hormone, Menopause
