Pharmacokinetics and pharmacodynamics of oral and transdermal 17β estradiol in girls with Turner syndrome

Martha Taboada, Richard Santen, John Lima, Jobayer Hossain, Ravinder Singh, Karen Oerter Klein, Nelly Mauras

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Context: The type, dose,and route of 17β-estradiol (E 2) used to feminize girls with Turnersyndrome (TS) is not well established. Objective: The objective of the studywasto characterize pharmacokineticsandpharmacodynamics of oral vs. transdermal E 2. Setting: The study was conducted at a clinical research center. Subjects: Ten girls with TS, mean age 17.7±0.4 (SE) yr and 20 normally menstruating controls (aged 16.8 ± 0.4 yr) participated in the study. Interventions: TS subjects were randomized 2wk each to: low-dose daily oral (0.5mg)and biweekly transdermal E 2 (0.0375 mg) with 2 wk washout in between or high-dose oral (2.0 mg) and transdermal (0.075 mg), studied for 24 h each. Tandem mass spectrometry E 2 and estrone (E 1) assays and a recombinant cell bioassay were used. Results: Controls consisted of the following: E 2, 96±11 pg/ml (SE), E 1, 70± 7(meanfollicular/luteal). TS consisted of the following: E 2, average concentration on low-dose oral, 18±2.1 pg/ml, low-dose transdermal, 38 ± 13, high-dose oral, 46 ± 15, high-dose transdermal, 114 ± 31 pg/ml. E 1 concentrations were much higher on oral E 2 (low or high dose) than transdermal in TS and higher than controls. Bioestrogen was closest to normal in the high-dose transdermal group. LH and FSH decreased more in transdermal than oral low-dose routes and similarly in the high-dose oral and transdermal groups. IGF-I concentrations were variable (P = NS) among groups, and low-density lipoprotein/high-density lipoprotein cholesterol responses were variable. Conclusions: Transdermal E 2 results in E 2, E 1, and bioestrogen concentrations closer to normal and achieves greater suppression of LH/FSH in lower doses compared with normal. Whether the longterm metabolic effects of estrogen differ using the same form of E 2, depending on route, awaits further study in TS.

Original languageEnglish (US)
Pages (from-to)3502-3510
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number11
StatePublished - Nov 2011

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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