A CLINICAL EVALUATION OF DIENESTROL, A SYNTHETIC ESTROGEN1

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Abstract
The clinical response to dienestrol (4:4[image] dihydroxy-[gamma]-[delta]-diphenyl-[beta]:[delta] hexadiene was evaluated in 82 patients with various conditions requiring estrogen therapy. Relief from menopausal symptoms was obtained in 40 [female] [female] with daily oral dosages of 0.1 to 1.0 mg. (av. 0.43 mg.). Larger dosages were required to raise the estrogen deficiency vaginal smear to a slight estrogen effect (av. 0.77 mg.) or to a marked estrogen effect (av. 1.8 mg.). Bleeding during treatment or on withdrawal occurred in only 2 patients on therapeutic dosages and in 2 others on higher dosages. In 6 cases of a trophic vaginitis, good results were obtained with local application of dienestrol vaginal cream (0.5 mg. in 5 ml. dose). In 9 younger [female][female] with amenorrhea associated with primary ovarian deficiency, it was difficult to induce withdrawal bleeding with relatively high dosages of dienestrol. In 26 postpartum patients, inhibition of lactation and breast engorgement were readily obtained with 1.0 mg. daily for 3 days and 0.5 rag. thereafter for one wk. These observations suggest that dienestrol has a relatively marked inhibitory effect on the pituitary and weak estrogenic effect on the endometrium and vaginal mucosa, making it a particularly useful estrogen for the treatment of the menopausal syndrome or for suppression of lactation. In 25 patients treated for 4-16 mos. (av. 7.3 mos.), no evidence of toxicity was noted or any significant changes in blood count, urinalysis or liver function test. No symptoms of intolerance occurred in dosages up to 6 mg. daily.

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