Methods and intervention

Participants were women in perimenopause characterized by hormonal fluctuation and symptomatic presentation. The intervention group received transdermal estradiol to provide systemic estrogen replacement while bypassing hepatic first-pass metabolism, alongside oral micronized progesterone to ensure endometrial protection and physiologic progestogenic activity. Outcomes assessed included vasomotor symptoms, sleep quality, psychoemotional status, and overall quality of life, with safety monitored through reported adverse effects and clinical parameters.

Key findings

The study demonstrated statistically significant improvements in vasomotor symptoms, including reductions in frequency and severity of hot flashes and night sweats, alongside measurable improvements in sleep quality and psychoemotional stability in the treatment group compared to controls. These effects are consistent with restoration of estrogen-mediated modulation of thermoregulatory centers and neurotransmitter systems, as well as the known GABAergic and sedative properties of micronized progesterone.

Hormonal and physiological effects

Transdermal estradiol contributed to stabilization of fluctuating endogenous estrogen levels, a key driver of perimenopausal symptomatology, while micronized progesterone addressed luteal phase insufficiency common in this population. The combined regimen supported more consistent neuroendocrine signaling, which is relevant for hypothalamic-pituitary-adrenal (HPA) axis regulation, sleep architecture, and cognitive-emotional processing.

Safety and tolerability

The therapy was well tolerated, with no significant adverse safety signals reported within the study period. The use of transdermal estradiol is particularly relevant given its avoidance of hepatic metabolism and associated lower impact on coagulation factors, while micronized progesterone demonstrated a favorable profile compared to synthetic progestins in terms of metabolic and neuropsychiatric effects.

You can view the full study, here: https://jbiochemtech.com/article/transdermal-estra...