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Estrogen Pellet Therapy in the Menopause

Department of Gynccology, Johns Hopkins University Baltimore, Maryland

IN THE TREATMENT of patients with menopausal symptoms, estrogen replacement therapy has earned for itself a well-established place. The procedure of administering the hormone parenterally two or three times a week, in order to maintain a sufficient level in the tissues, has decided disadvantages; it is time-consuming for both the patient and the physician, and the frequent hypodermic injections are disagreeable. In order to circumvent the inconvenience and unpleasantness of administration, the use of the orally active estrogen, stilbestrol, has become widespread among gynecologists and practitioners.

There can be no doubt of the effectiveness of stilbestrol in controlling menopausal symptoms, but its administration is often associated with undesirable side effects. We have found that 12.5 per cent of 32 patients in the dispensary, and a much higher percentage among private patients, who were treated with oral stilbestrol, were required to discontinue it because of nausea and vomiting. It has been demonstrated that many patients can take very small doses of stilbestrol without nausea or vomiting, but the percentage of relief of symptoms in a dosage of 0.5 mg. or less is much

Received April 14, 1943.