Quote from: Cindy on December 10, 2017, 02:52:34 PM
I should note that oestrogen therapy for prostatic cancer has not been used for many years due to the side effects
Med Sci Monit. 2012 Apr;18(4):CR260-4. (5 years ago)
"Patients with prostate cancer progressing after androgen ablation therapy and chemotherapy were treated with transdermal estradiol patches (...) applied weekly and assessed for tolerability and biochemical activity."
"Twenty-two patients were treated on study with all patients evaluable for safety"
"Therapy was well tolerated and no thrombotic events were observed."
"The median age was 72 years (range 57–85)."
"Treatment with transdermal estradiol was well tolerated with no grade 4 toxicities and no evidence of thrombotic events (Table 3)."
"In the 20 patients treated beyond cycle 1, no one was removed from the study due to toxicity with the most common reason for discontinuing therapy was disease progression. The only grade 3 toxicities were transient increase in AST and increased alkaline phosphatase, likely due to bone progression."
"Similar to the experience by Beer et al., our study supports the safety of transdermal estradiol for future studies. Both in the Beer study and our study, therapy was well tolerated without any thrombotic events. In fact, prior studies have supported that estrogen administrated via intramuscular or a transdermal route, as opposed to orally, is less thrombogenic by avoiding exposure of the liver to high estrogen concentrations from the hepatic circulation, which results in increased synthesis of thrombophilic coagulation factors [22–25]."
Lancet Oncol. 2013 Apr;14(4):306-16. (4 years ago)
"Initially, patients in the oestrogen-patch group received (...) patches (...) to be self-administered and changed twice weekly for 4 weeks. The number of patches was reduced (...) if castrate testosterone concentrations in serum of 1·7 nmol/L or lower were achieved (regimen one)."
"Median age was 74 years"
"The rate of cardiovascular events was 2·9% higher in the oestrogen-patch group than in the LHRHa group (95% CI −4·2 to 10·1).
The wide 95% CI suggests no significant difference between groups"
"
Of the 18 events among men assigned oestrogen patches, nine (50%) occurred more than 30 days (and in four cases more than 12 months) after oestrogen was stopped and LHRHa was started."
"
several events attributed to the oestrogen-patches group occurred in men who had received oestrogen therapy for only a short period, or who had stopped treatment for a long time before the event occurred, or both. The analysis according to treatment at the time of the event provides a more standard assessment of toxic effects."
"No grade 4 or 5 adverse events had been reported by 6 months"
"Parenteral oestrogen could be a potential alternative to LHRHa in management of prostate cancer if efficacy is confirmed.
On the basis of our findings, enrolment in the PATCH trial has been extended, with a primary outcome of progression-free survival."
49-92 yrs old
BJU Int. 2017 May;119(5):667-675."To compare quality-of-life (QoL) outcomes at 6 months between men with advanced prostate cancer receiving either transdermal oestradiol (tE2) or luteinising hormone-releasing hormone agonists (LHRHa) for androgen-deprivation therapy (ADT)."
"In all,
727 men were enrolled between August 2007 and October 2015 (412 tE2, 315 LHRHa) with QoL questionnaires completed at both baseline and 6 months."
"At 6 months, patients on tE2 reported higher global QoL than those on LHRHa (mean difference +4.2, 95% confidence interval 1.2-7.1; P = 0.006), less fatigue, and improved physical function. Men in the tE2 arm were less likely to experience hot flushes (8% vs 46%), and report a lack of sexual interest (59% vs 74%) and sexual activity, but had higher rates of significant gynaecomastia (37% vs 5%). The higher incidence of hot flushes among LHRHa patients appear to account for both the reduced global QoL and increased fatigue in the LHRHa arm compared to the tE2 arm."
"Patients receiving tE2 for ADT had better 6-month self-reported QoL outcomes compared to those on LHRHa, but increased likelihood of gynaecomastia.
The ongoing trial will evaluate clinical efficacy and longer term QoL."
Quote from: josie76 on December 10, 2017, 06:08:21 PMBTW I found a few studies that showed oral administration resulted is sufficient blood levels. One study specifically used a mid dose (I assume even study quotes of dosages are not allowed) of micronized progesterone administered orally could boost post menapausal women's levels to that of mid-luteal phase. This would indicate more substance to oral administration than some others would suggest. These studies show oral administration blood levels can reach their target levels at past 12 hours from administration.
Personally I am waiting to see what my levels are when I get another blood test. Then once I know my levels based on my current oral dose of P I will discuss with my endo on what I wish to do dosage wise.
The problem with oral micronized progesterone (I urge you to consult more studies and check pharmacokinetics, hour by hour) is that levels peak and dip quite quickly so that within 3-4 hours after the peak, levels have already dropped significantly and this can lead to mood swings. Taken rectally and vaginally, levels are more constant and drop much later. With IM, it needs to be injected daily as by 24 hours, levels have SIGNIFICANTLY dropped.
