Improved compliance and patient satisfaction with estradiol vaginal tablets in postmenopausal women previously treated with another local estrogen therapy

Abstract

Up to half of all postmenopausal women will experience changes in the genitourinary tract induced by the hypoestrogenic state, collectively known as vaginal atrophy. Vaginally administered local estrogen therapy (LET) is the standard of care for symptoms of vaginal atrophy that do not respond to nonhormonal interventions. Several LET formulations are available, and choice of therapy is based largely on patient needs and preferences. This online survey of postmenopausal LET users was conducted to investigate reasons for switching to vaginal estradiol tablets from other formulations and to evaluate factors associated with patient preference for and compliance with use of LET. Data was analyzed from 73 respondents currently using estradiol vaginal tablets who have previously used the estradiol vaginal ring, estradiol vaginal cream, and/or conjugated estrogen vaginal cream. Patients in this survey rated vaginal symptoms of vaginal atrophy as being more bothersome than urinary symptoms. Respondents preferred their current treatment with the vaginal tablet to their previous treatment with a cream or ring. The preference for tablets over creams was mainly related to formulation and application rather than to any perceived safety issues. Tablets were perceived as efficacious, convenient, and neat to apply. The study participants also reported a longer duration of tablet use compared with creams or rings, and greater compliance with vaginal tablets than with vaginal cream. This study provides new insights into reasons for patient noncompliance with estrogen cream or ring therapy that can be used to maximize patient adherence with LET.

Postmenopausal vaginal atrophy: evaluation of treatment with local estrogen therapy

“…In another recently performed online survey, which considered data from 73 postmenopausal women from the United States who had switched to vaginal tablets from other local estrogen preparations, respondents also exhibited a preference for vaginal tablets over vaginal creams; this was mainly a consequence of formulation and application, with tablets being perceived as efficacious, convenient, and neat to apply 19. Such results are consistent with an earlier randomized study involving 159 postmenopausal women from Canada, in which significantly more users of vaginal tablets than vaginal cream rated application as “easy” and “comfortable”, and the medication as “very acceptable” 20…”

“…These results are in line with other published data. In the US study by Minkin et al,19 women’s favorable attitudes towards vaginal tablets rather than vaginal cream were borne out by tablet users reporting greater compliance and a longer duration of therapy. In the randomized study involving women from Canada, women’s positive views of vaginal tablets over vaginal cream appeared to translate into lower study withdrawal rates (10% versus 32%) 20…”

Evaluation of Fractional CO2 Laser Treatment Efficacy and Comparison to Vaginal Conjugated Estrogen Cream in Postmenopausal Women with Vulvovaginal Atrophy: A Randomized Clinical Trial

“…Menopause is a natural stage in women's life accompanied with decreased estrogen secretion (Minkin, Maamari, & Reiter, 2013;Sparavigna, Tenconi, De Ponti, Bulgheroni, & Scarci, 2013). This reduction is accompanied with multiple alterations in vaginal mucus that may result in vaginal atrophy with symptoms such as dryness, redness, burning sensation, and post-coital bleeding (Mac Bride, Rhodes, & Shuster, 2010;Santoro & Komi, 2009).…”

Vitamin D Proliferates Vaginal Epithelium through RhoA Expression in Postmenopausal Atrophic Vagina tissue

“…Menopause is the stage of a woman’s reproductive life that is accompanied by estrogen deficiency. This deficiency has many negative effects on the vaginal mucosa, such as dryness, irritation, and vaginal atrophy (Minkin et al, 2013; Reiter, 2013). Although vaginal estrogens are an effective treatment for vulvovaginal atrophy, there are concerns in some women with a history of breast or endometrial hyperplasia (Unfer et al, 2004).…”