Estrogens vaginal preparations

Estrogens, vaginal preparations conjugated estrogens estradiol... 

Because of the beneficial effects of the vaginal delivery of estrogens and progesterone in comparison to their oral delivery, various vaginal preparations (tablets, suppositories, gels, rings) of these agents are now available, for use ... 

Conjugated Estrogens (Premarin) Sulfate esters of estrogenic substances. Less potent than estradiol. Oral, IV, or vaginal preparations are effective. 

Patients at low risk of developing osteoporosis who manifest only mild atrophic vaginitis can be treated with topical preparations. The vaginal route of application is also useful in the treatment of urinary tract symptoms in these patients. It is important to realize, however, that although locally administered estrogens escape the first-pass effect (so that some undesirable hepatic effects are reduced), they are almost completely absorbed into the circulation, and these preparations should be given cyclically. 

These drugs are contraindicated in patients with thrombophlebitis, thromboembolic phenomena, and cardiovascular and cerebrovascular disorders or a past history of these conditions. They should not be used to treat vaginal bleeding when the cause is unknown. They should be avoided in patients with known or suspected tumors of the breast or other estrogen-dependent neoplasms. Since these preparations have caused aggravation of preexisting disorders, they should be avoided or used with caution in patients with liver disease, asthma, eczema, migraine, diabetes, hypertension, optic neuritis, retrobulbar neuritis, or convulsive disorders. 

Crandall, C. (2002), Vaginal estrogen preparations A review of safety and efficacy for vaginal atrophy. /. Womens Health (Larchmt.), 11,857-877. 

Estrogens arc commercially available in a wide variety of dosage fonns oral tablets, vaginal creanrs and foams, irans-demial patches, and iniromascular dosage preparations. 

Estrogens are not frequently used topically except in vaginal and scalp preparations. Fregert and Rorsmann (1960,1962) described an allergic patient sensitized by a hair lotion containing diethylstilbestrol. Cross-sensitization was demonstrated to dienoestrol, hexoestrol, bisphenol A, p-benzylphenol, the monobenzylether of hydroquinone, and the benzylester of p-hydroxybenzoic acid. 

The use of estrogenic and other hormone-containing preparations in medical and cosmetic applications could constitute another form of exposure to EDCs. One of the main medical applications of the synthetic hormones is in the female contraceptive pill. The detergent nonoxynol, whose main component is nonylphenol (an estrogen mimic), is used as a vaginal lubricant and spermicide. 

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