Comparison of usefulness of estradiol vaginal tablets and estriol vagitories for treatment of vaginal atrophy

Dugal, Randi; Hesla, K; Sørdal, Terje; Aase, Kathe Helen; Lilleeidet, Oddvar; Wickstrøm, E

doi:10.1034/j.1600-0412.2000.079004293.x

Cited by 46 publications

(26 citation statements)

References 11 publications

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“…Ten studies reported endometrial biopsy findings. 31,32,34,38,40,42,44–48 Among patients with an intact uterus (during and up to 1 year of vaginal estrogen use), endometrial pathology was rarely abnormal; this consisted of two cases of hyperplasia with atypia in a study of 165 participants (1.2%) followed for 12 weeks; one received an estradiol vaginal ring and the other estriol cream. 34 Differences in serum estradiol levels were not identified between various estrogen delivery mechanisms with the exception of one study comparing the 25-microgram estradiol vaginal tablet to 1.25 mg conjugated estrogen cream daily (ie, 2 g cream daily); a higher percentage of the patients given this conjugated estrogen cream dose had serum estradiol levels above postmenopausal norms.…”

Section: Resultsmentioning

confidence: 99%

Vaginal Estrogen for Genitourinary Syndrome of Menopause

Rahn

Carberry

Sanses

et al. 2014

Obstetrics &Amp; Gynecology

257

142

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OBJECTIVE To comprehensively review and critically assess the literature on vaginal estrogen and its alternatives for women with genitourinary syndrome of menopause and to provide clinical practice guidelines. DATA SOURCES MEDLINE and Cochrane databases were searched from inception to April 2013. We included randomized controlled trials and prospective comparative studies. Interventions and comparators included all commercially available vaginal estrogen products. Placebo, no treatment, systemic estrogen (all routes), and nonhormonal moisturizers and lubricants were included as comparators. METHODS OF STUDY SELECTION We double-screened 1,805 abstracts, identifying 44 eligible studies. Discrepancies were adjudicated by a third reviewer. Studies were individually and collectively assessed for methodologic quality and strength of evidence. TABULATION, INTEGRATION, AND RESULTS Studies were extracted for participant, intervention, comparator, and outcomes data, including patient-reported atrophy symptoms (eg, vaginal dryness, dyspareunia, dysuria, urgency, frequency, recurrent urinary tract infection (UTI), and urinary incontinence), objective signs of atrophy, urodynamic measures, endometrial effects, serum estradiol changes, and adverse events. Compared with placebo, vaginal estrogens improved dryness, dyspareunia, urinary urgency, frequency, and stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). Urinary tract infection rates decreased. The various estrogen preparations had similar efficacy and safety; serum estradiol levels remained within postmenopausal norms for all except high-dose conjugated equine estrogen cream. Endometrial hyperplasia and adenocarcinoma were extremely rare among those receiving vaginal estrogen. Comparing vaginal estrogen with nonhormonal moisturizers, patients with two or more symptoms of vulvovaginal atrophy were substantially more improved using vaginal estrogens, but those with one or minor complaints had similar symptom resolution with either estrogen or nonhormonal moisturizer. CONCLUSION All commercially available vaginal estrogens effectively relieve common vulvovaginal atrophy-related complaints and have additional utility in patients with urinary urgency, frequency or nocturia, SUI and UUI, and recurrent UTIs. Nonhormonal moisturizers are a beneficial alternative for those with few or minor atrophy-related symptoms and in patients at risk for estrogen-related neoplasia. CLINICAL TRIAL REGISTRATION PROSPERO International prospective register of systematic reviews, http://www.crd.york.ac.uk/PROSPERO/,CRD42013006656.

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Section: Resultsmentioning

confidence: 99%

Vaginal Estrogen for Genitourinary Syndrome of Menopause

Rahn

Carberry

Sanses

et al. 2014

Obstetrics &Amp; Gynecology

257

142

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“…In general, when compared with vaginal estrogen creams or suppositories, tablets provide a more consistent dose of the hormone, reduce potential leakage, and are associated with greater patient adherence 6,7. All treatments provided equivalent relief of the symptoms of VVA based on composite scores of vaginal symptoms (dryness, soreness, and irritation).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of ultra-low-dose Vagifem (10 mcg)

Chollet¹

2011

PPA

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Vulvovaginal atrophy [VVA] is defined as inflammation of the vaginal epithelium due to atrophy secondary to decreased levels of circulating estrogen. There is currently only one approved method for the treatment of VVA, and that is the administration of exogenous estrogens. Overall, the ideal VVA treatment must have benefits, minimize risks, and enhance compliance in the patient while optimizing cost-effectiveness. Unfortunately, of the approximate 25% of symptomatic women that are thought to seek medical help, the proportion that receives hormone therapy may be small and its duration of use is short. Women have been very reluctant to take hormone therapy due to widely publicized results of the risks associated with hormone therapy. Thus, while menopausal hormone therapy was once accepted as the ideal approach for optimizing changes associated with menopause, prospective randomized clinical trials have challenged that view and have led to a marked decrease in the use of such therapy and increased search for low-dose therapies. This article will highlight the efficacy and safety of recently FDA-approved Vagifem (10 mcg) in treatment of VVA.

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“…In a Cochran Review evaluating local estrogen therapy for vaginal atrophy, data were extracted from 19 studies in 4162 menopausal women involving vaginal rings, creams, tablets, and gels (56). All estrogen products studied appeared to be equally effective for relief of the symptoms of vaginal atrophy (29,37,62–73). Secondary outcome analysis in many of these studies also showed acidification of the vaginal pH and an increase in the VMI in favor of mature squamous cells.…”

Section: Hormonal Therapies For Atrophic Vaginitismentioning

confidence: 99%

Atrophic vaginitis

Stika

2010

Dermatologic Therapy

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With the loss of estrogen that occurs with menopause, physiologic and structural changes occur within the vulvovaginal mucosa that lead to a condition commonly called atrophic vaginitis. Although mild genital changes occur in most women, 10-47% of postmenopausal women will develop one or more debilitating symptoms that include vulvovaginal dryness, dyspareunia, vulvar itching or pain, recurrent urinary tract infections, as well as abnormal vaginal discharge. Topical estrogen replacement therapies reverse these mucosal changes and are effective treatments for the symptoms of atrophic vaginitis. Vaginal moisturizers and lubricants also provide symptomatic relief for vaginal dryness and dyspareunia, respectively.

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Comparison of usefulness of estradiol vaginal tablets and estriol vagitories for treatment of vaginal atrophy

Abstract: Estradiol vaginal tablets provides an effective alternative to traditional forms of local estrogen therapy.

Cited by 46 publications

References 11 publications

Vaginal Estrogen for Genitourinary Syndrome of Menopause

Vaginal Estrogen for Genitourinary Syndrome of Menopause

Efficacy and safety of ultra-low-dose Vagifem (10 mcg)

Atrophic vaginitis

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