Hum. Reprod. Advance Access originally published online on February 24, 2006
Human Reproduction 2006 21(6):1635-1642; doi:10.1093/humrep/del034
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No increase in C-reactive protein levels during intranasal compared to oral hormone therapy in healthy post-menopausal women
1 Project ‘Ageing Women’ and 1,2Institute for Cardiovascular Research-Vrije Universiteit (ICaR-VU), 1Department of Obstetrics & Gynaecology and 2 Department of Clinical Chemistry, VU University Medical Center, Amsterdam and 3 Department of Obstetrics & Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
4 To whom correspondence should be addressed at: Department of Obstetrics & Gynaecology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: mj.vandermooren{at}vumc.nl
BACKGROUND: Inflammation plays an important role in the development of atherosclerotic disease. Oral post-menopausal hormone therapy increases serum C-reactive protein (CRP) levels. This study compared the effects of intranasal and oral administration of 17
-estradiol (E2) combined with norethisterone acetate (NETA) on markers of inflammation in healthy post-menopausal women. METHODS: Ninety healthy post-menopausal women (age 56.6 ± 4.7 years) participated in this 1-year trial. After computerized block randomization, they daily received, in a double-blind fashion, either intranasal E2/NET [175 µg/275 µg (n = 47)] or oral E2/NETA [1 mg/0.5 mg (n = 43)]. Concentrations of high sensitivity CRP and adhesion molecules were measured at baseline and after 12, 24 and 52 weeks of treatment. RESULTS: CRP levels were increased (P = 0.001) in the oral but not in the intranasal group. The increase in the oral group was highest at week 12 (64.9%) and was larger (P < 0.01) compared with the non-significant increase (8.6%) found in the intranasal group. Both groups showed decreases (P < 0.001) in soluble vascular cell adhesion molecule (sVCAM), soluble intracellular adhesion molecule (sICAM) and sE-selectin. The decreases were larger (P < 0.01) in the oral than in the intranasal group. CONCLUSION: Intranasal E2/NET therapy did not significantly increase CRP levels, in contrast to the increase observed in the oral E2/NETA treatment group. Both intranasal and oral therapy lowered plasma concentrations of adhesion molecules, however, more so in the oral group.
Key words: adhesion molecules/C-reactive protein/intranasal/menopause/norethisterone
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