Menopause: Intranasal Oestradiol
The most recent development has been the appearance of intranasal oestrogen, Aerodiol, which is certainly as effective as oral oestradiol 2mgs or oestradiol patch 50mgs. It has an odd pharmacokinetic picture, as there is a massive peak of oestradiol of 4000 pmol/l at 30 minute (the normal range is 100 to 1400 pmol/l), which is reduced to normal postmenopausal values within 4 hours. I believe this may be a huge advantage, particularly in patients with hormone responsive depression, like postnatal depression, premenstrual depression and climacteric depression. However this hypothesis needs confirmation by clinical studies.