[Postmenopausal bleeding following the application of an estrogen-containing hair lotion--concomitant endocrine changes]

Application of a commercially available hair lotion containing high concentrations of oestradiol led to uterine bleeding in a 76-year old patient. Histological examination of the endometrium showed typical proliferation. Oestradiol blood levels were in the normal range of the follicular or luteal phase, LH- and FSH-serum concentrations were suppressed. After discontinuing the application of the assay used (20 pg/ml) and gonadotrophins rose to normal postmenopausal levels. These findings prove that after local application of oestradiol on the scalp, percutaneous resorption of the steroid is significant and systemic oestrogen effects have to be taken into account.