[Comparative high rising dose study of oral 17-alpha-ethinylestradiol (EE2), estriol (E3), and parenteral 16-alpha-17-beta-estrioldihemisuccinate (E3-suc) in their effects on serum levels of glutamate transaminase (GOT), pyruvate transaminase (GPT), leucine amino peptidase (LAP), alkaline phosphatase (AP), and bilirubin in 30 hysterectomized and ovarectomized women (author's transl)].

UNLABELLED: 30 hysterectomized and ovarectomized women were treated with three different estrogens: EE2 orally, E3 orally, and E3-suc intramuscularly. Each patient received one substance over 5 days doubling the dose every consecutive day, and switching to another estrogen after a treatment free interval of 2 days, rising the dosage of the second preparation twofold every consecutive day over another 5 days. Thus, each patient served as her own control with respect to 2 of the 3 tested estrogens. Six groups were required to test all sequences possible. The patients were allocated by random. GOT, GPT, LAP, AP and bilirubin were estimated daily over 2 weeks. The starting dose of EE2 was 0.25 mg, of E3 2 mg, and of E3-suc 2.5 mg.

RESULTS: There were marked elevations of all serum enzymes during the week of EE2 treatment. If EE2 was given in the first week, and either E3 or E3-suc in the second one there was a prompt fall of all enzyme levels in spite of the approximately tenfold higher dose of the latter two estrogens. There were only minor elevations of the enzymes after oral E3 and parenteral E3-suc in some subjects and no differences of response between these two estrogens. Bilirubin reacted with an overall rise in the majority of patients irrespective of the type of estrogen.