Institutional members access full text with Ovid®

Share this article on:

Intranasal hormone replacement therapy

Wattanakumtornkul, Saranya MD; Pinto, Anil B. MD; Williams, Daniel B. MD


Although the optimal route of delivery for hormone replacement therapy has not yet been determined, desirable qualities would include good efficacy, easy administration, minimal side effects, and optimal therapeutic profile. This would potentially serve to improve patient compliance and satisfaction. The intranasal route has been evaluated for the administration of menopausal hormones and seems to fulfill these requirements. The intranasal route would also seem to be a viable alternative for drugs that are poorly absorbed after ingestion by avoiding hepatic first-pass elimination. The intranasal route is, therefore, innovative for the delivery of natural sex steroids in postmenopausal women receiving hormone replacement therapy. Early studies demonstrate that it is safe, effective, and acceptable to postmenopausal women. In addition, the nasal administration of a combination of estradiol and progesterone would seem to be an attractive way to deliver hormones to nonhysterectomized postmenopausal women. Providing alternative routes of administration may also enhance compliance.

From the Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO.

Received February 27, 2002; revised and accepted July 1, 2002.

Address reprint requests to Daniel B. Williams, MD, Alliance Center for Reproductive Health, 2123 Auburn Ave., Suite 415, Cincinnati, Ohio 45219, USA. E-mail:

©2003The North American Menopause Society