Micronized Versus Nanoparticles in Transdermal Hormone Replacement Therapy: Effects on Blood Pressure and Inflammatory Parameters in Brazilian Postmenopausal Women

Purpose: To assess the effects of micronized (MIC) and nanoparticulate (NANO) transdermal hormone therapy (THT) on blood pressure, fasting insulin and ultra-sensitive C-reactive protein (CRP) in postmenopausal women. Methods: In this open label study, 27 postmenopausal women, with no clinical evidence of cardiovascular disease, were randomly divided in two groups. During 12 weeks, fifteen patients received on the left forearm micronized (MIC) THT (micronized 17β-estradiol 2.5 mg/ day + progesterone 100 mg/day). Fourteen patients received a nanoparticulate (NANO) THT (nanoparticulate 17β-estradiol 2.5 mg/ day + progesterone 100mg/day). After treatment patients were evaluated. Baseline and Post-THT measures were determined: Insulin, body mass index, waist circumference, blood pressure, CRP-stratified levels, total progesterone, TSH and FSH levels. The study was registered at clinical trials.gov (NCT02467673). Results: The mean age was 61.4 years. CRP-stratified high levels decreased in a higher number on NANO THT patients, who moved from high to intermediate and low levels (P<0.05). No effect was observed on TSH and FSH serum levels in both groups. Insulin levels decreased significantly on NANO group (P<0.05) patients and did not change on MIC group. Conclusions: Micronized and Nanoparticulate THT for 12 weeks had beneficial effects in postmenopausal women with no clinical evidence of cardiovascular disease.