Transdermal estradiol overall safety profile.

The results of both single- and multicenter clinical studies have revealed that the transdermal therapeutic system of estrogen administration (Estraderm, CIBA Pharmaceutical Co., Summit, New Jersey) is both effective and well tolerated. In contrast to oral conjugated estrogens, the patch has no effect on certain liver proteins. Safety variables measured during one study showed no biochemical changes. Moderate bleeding has occurred in some patients with an intact uterus but can be controlled by the addition of a progestogen. The incidence of endometrial hyperplasia and breast tenderness has been relatively low, and minor side effects (such as fluid retention) have been limited. Several investigators have evaluated skin irritation resulting from the systems. Some erythema has been reported, but serious ulcerations or sloughing did not occur. A survey of patient attitudes comparing oral administration and transdermal systems indicated a preference for the transdermal method.