Hum. Reprod. Advance Access published online on February 24, 2006
Human Reproduction, doi:10.1093/humrep/del034
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1 Department of Obstetrics & Gynaecology, VU University Medical Center, Amsterdam
* To whom correspondence should be addressed. 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
Received November 14, 2005
Revised January 17, 2006
Accepted January 19, 2006
Article
No increase in C-reactive protein levels during intranasal compared to oral hormone therapy in healthy post-menopausal women
M. Hemelaar 1,
P. Kenemans 1,
C.G. Schalkwijk 2,
D.D.M. Braat 3,
and
M.J.van der Mooren 1 *
2 Department of Clinical Chemistry, VU University Medical Center, Amsterdam
3 Department of Obstetrics & Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
M.J.van der Mooren, E-mail: mj.vandermooren{at}vumc.nl
Abstract 
-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 doubleblind
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 intranasalsal and oral therapy lowered plasma concentrations of adhesion molecules, however, more so in the oral group.
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