Effect of Oral Estradiol and Progesterone Therapy on Vaginal Cytokines in Postmenopausal Women

The purpose of this study is to compare the vaginal health between premenopausal and postmenopausal women before and after using oral "estradiol" for 14 days then "estradiol" and "progesterone" for 14 days.

Study Overview

• Status: Completed
• Conditions: Menopause
• Intervention / Treatment: Drug: oral estradiol 1.0 mg; Drug: oral progesterone 100 mg

Detailed Description

This research project recruits 10 healthy, premenopausal women (aged 20-40 years-old) with regular menstrual cycle with interval of 24-35 days and duration of 2-7 days and 10 healthy postmenopausal women (aged 45-60 years-old) with an intact uterus and at least 12 months but not more than 36 months of spontaneous amenorrhea.

Premenopausal women will not receive any study medication(s). Postmenopausal women will be assigned the intervention described below.

• Oral "estradiol" 1.0 mg tablet for 14 days, then oral "estradiol" 1.0 mg tablet and "progesterone" 100 mg capsule for 14 days

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • Virginia
    • Norfolk, Virginia, United States, 23507
      • David Archer, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Premenopausal and Postmenopausal women:

  1. Female between the ages of 20 and 40 years (premenopausal arm), OR be a female between the ages of 45 and 65 years (postmenopausal arm) willing to participate in the study, as documented by signing the informed consent form.
  2. Postmenopausal women with an intact uterus and at least 12 months of spontaneous amenorrhea (postmenopausal arm), OR be a premenopausal women with regular menstrual cycle with interval of 24-35 days and duration of 2-7 days (premenopausal arm).
  3. No oral hormone therapy for 8 weeks and transdermal or vaginal hormone therapy for 4 week prior to the study.
  4. Willing to use oral hormone therapy during the study period (postmenopausal women only).
  5. Willing to abstain from using products (other than study medication) that contain estrogen, progestin, or progesterone throughout study participation.
  6. Have general good health.
  7. Willing to refrain from sexual intercourse for 48 hours before vaginal sample collection.
  8. Willing to abstain from use of vaginal product 7 days before vaginal sample collection.

Exclusion Criteria:

• To participate in the study, a subject must NOT

  1. Be allergic to estrogen or progesterone products
  2. Have active genital infection or inflammation based on vaginal wet preparation, power of hydrogen (pH), whiff test and potassium hydroxide (KOH) preparation 2.1 Vulvovaginal candidiasis, trichomonas vaginitis or bacterial vaginitis 2.2 Sexually transmitted diseases including herpes simplex viral infection, gonorrhea and Chlamydia
  3. Have a known contraindication for oral hormone therapy or allergy to use of estradiol and/or progesterone

  4. Have used estrogen alone or estrogen/progestin for any of the following time periods:

     4.1 Vaginal hormone products (ring, cream, gels) within 30 days prior to screening 4.2 Transdermal estrogen alone or estrogen/progestin products within 4 weeks prior to screening 4.3 Oral estrogen and/or progestin therapy within 8 weeks prior to screening 4.4 Progestational implants, estrogen or estrogen/progestational injectable drug therapy within 3 months prior to screening 4.5 Estrogen pellet therapy or progestational injectable drug therapy within 6 months prior to screening 4.6 Percutaneous estrogen lotions/gels within 4 weeks prior to screening

  5. Have used tamoxifen, raloxifene or other selective estrogen receptor modulators (SERMs) therapy within 8 weeks prior to screening
  6. Have used an intrauterine device (IUD) within 8 weeks prior to screening
  7. Have used vaginal products (pessary, tampon, tablets, douching) within 7 days prior to screening
  8. Have evidence of cervical, vaginal, or vulvar intraepithelial neoplasia or cancer
  9. Have a past or current history breast cancer, endometrial cancer or endometrial hyperplasia, hypertriglyceridemia or venous thromboembolism
  10. Be an immuno-compromised patient including those with human immunodeficiency viral infection, chronic glucocorticoid use or active treatment with immunosuppressive agents
  11. Have a history of or current evidence of thromboembolism
  12. Have evidence of uncontrolled Hypertension Blood pressure >140/100 mmHg
  13. Have confirmed Diabetes Mellitus
  14. Currently smoking
  15. For sexually active premenopausal women, should be protected against pregnancy by sterilization, condom use, abstinence, or same sex relationship

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: 1.Premenopausal women; No treatment
Experimental: 2.Postmenopausal women with hormones; Oral hormone therapy will be given to women in this group. Daily dose of oral "estradiol" 1 mg will be given the first 14 days after enrollment. Then a daily dose of oral "estradiol" 1 mg and "progesterone" 100 mg for 14 days will be given during the following 14 days.	Drug: oral estradiol 1.0 mg; one tablet of oral estradiol 1.0 mg once a day for 28 days; Other Names: Estrace; Drug: oral progesterone 100 mg; one tablet of oral progesterone 100 mg once a day for 14 days; Other Names: Prometrium

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Vaginal Cytokines at Baseline	Determine the differences in vaginal cytokines: interleukin (IL)-1β and IL-8 between premenopausal and postmenopausal women.	At baseline visit

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Vaginal Cytokines During Follow-up	Determine the changes in vaginal cytokines in postmenopausal women following treatment with estradiol then estradiol and progesterone compared to the normal menstrual cycle changes in young premenopausal women.	At 14 days and 28 days follow-up

Collaborators and Investigators

• Sponsor: Intira Sriprasert
• Collaborators: TherapeuticsMD
• Investigators: Study Director: David F Archer, MD, Eastern Virginia Medical School

Publications and helpful links

Helpful Links

• The manuscript is not yet on Pubmed but it is in press in Climacteric journal.

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2015
• Primary Completion (Actual): August 1, 2018
• Study Completion (Actual): August 1, 2018

Study Registration Dates

• First Submitted: July 30, 2014
• First Submitted That Met QC Criteria: August 21, 2014
• First Posted (Estimate): August 25, 2014

Study Record Updates

• Last Update Posted (Actual): March 19, 2020
• Last Update Submitted That Met QC Criteria: March 4, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Keywords: vaginal cytokine
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Estrogens; Progestins; Estradiol; Progesterone
• Other Study ID Numbers: CRC-VgCy

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO