960
Views
80
CrossRef citations to date
0
Altmetric
Original Article

Topical estrogen therapy in the management of postmenopausal vaginal atrophy: an up-to-date overview

&
Pages 91-105 | Received 07 Aug 2008, Accepted 28 Oct 2008, Published online: 03 Jul 2009

References

  • Johnston S L, Farrell S A, Bouchard C, et al. The detection and management of vaginal atrophy. J Obstet Gynaecol Can 2004; 26: 503–515
  • Dew J E, Wren B G, Eden J A. A cohort study of topical vaginal estrogen therapy in women previously treated for breast cancer. Climacteric 2003; 6: 45–52
  • Dennerstein L, Dudley E C, Hopper J L, Guthrie J R, Burger H G. A prospective population-based study of menopausal symptoms. Obstet Gynecol 2000; 96: 351–358
  • Stenberg A, Heimer G, Ulmsten U, Cnattingius S. Prevalence of genitourinary and other climacteric symptoms in 61-year-old women. Maturitas 1996; 24: 31–36
  • Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2006, 4, CD001500
  • Ballagh S A. Vaginal hormone therapy for urogenital and menopausal symptoms. Semin Reprod Med 2005; 23: 126–140
  • Barlow D H, Samsioe G, van Geelen J M. A study of European women's experience of the problems of urogenital ageing and its management. Maturitas 1997; 27: 239–247
  • Cardozo L, Bachmann G, McClish D, Fonda D, Birgerson L. Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol 1998; 92: 722–727
  • Van Geelen J M, van de Weijer P H, Arnolds H T. Urogenital symptoms and resulting discomfort in non-institutionalized Dutch women aged 50–75 years. Int Urogynecol J Pelvic Floor Dysfunct 2000; 11: 9–14
  • Greendale G A, Judd H L. The menopause: health implications and clinical management. J Am Geriatr Soc 1993; 41: 426–436
  • Iosif C S, Bekassy Z. Prevalence of genito-urinary symptoms in the late menopause. Acta Obstet Gynecol Scand 1984; 63: 257–260
  • Kalogeraki A, Tamiolakis D, Tzardi M, et al. Cigarette smoking as a risk factor for intraepithelial lesion of the cervix uteri. In Vivo 1996; 10: 613–616
  • Couzi R J, Helzlsouer K J, Fetting J H. Prevalence of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J Clin Oncol 1995; 13: 2737–2744
  • Ganz P A, Rowland J H, Desmond K, Meyerowitz B E, Wyatt G E. Life after breast cancer: understanding women's health-related quality of life and sexual functioning. J Clin Oncol 1998; 16: 501–514
  • Bachmann G A. Vasomotor flushes in menopausal women. Am J Obstet Gynecol 1999; 180: S312–S316
  • Oriba H A, Maibach H I. Vulvar transepidermal water loss (TEWL) decay curves. Effect of occlusion, delipidation, and age. Acta Derm Venereol 1989; 69: 461–465
  • Ballagh S A. Vaginal rings for menopausal symptom relief. Drugs Aging 2004; 21: 757–766
  • Bachmann G A, Nevadunsky N S. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician 2000; 61: 3090–3096
  • Nilsson K, Risberg B, Heimer G. The vaginal epithelium in the postmenopause – cytology, histology and pH as methods of assessment. Maturitas 1995; 21: 51–56
  • Long C Y, Liu C M, Hsu S C, Wu C H, Wang C L, Tsai E M. A randomized comparative study of the effects of oral and topical estrogen therapy on the vaginal vascularization and sexual function in hysterectomized postmenopausal women. Menopause 2006; 13: 737–743
  • Barlow D H, Cardozo L D, Francis R M, et al. Urogenital ageing and its effect on sexual health in older British women. Br J Obstet Gynaecol 1997; 104: 87–91
  • Nachtigall L E. Comparative study: Replens versus local estrogen in menopausal women. Fertil Steril 1994; 61: 178–180
  • Loprinzi C L, Abu-Ghazaleh S, Sloan J A, et al. Phase III randomized double-blind study to evaluate the efficacy of a polycarbophil-based vaginal moisturizer in women with breast cancer. J Clin Oncol 1997; 15: 969–973
  • Bygdeman M, Swahn M L. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas 1996; 23: 259–263
  • Johnston S L. Current and future treatment of atrophic vaginitis due to estrogen deficiency. J Soc Obstet Gynecol 1998, Canada Suppl: 16–22
  • Upmalis D H, Lobo R, Bradley L, Warren M, Cone F L, Lamia C A. Vasomotor symptom relief by soy isoflavone extract tablets in postmenopausal women: a multicenter, double-blind, randomized, placebo-controlled study. Menopause 2000; 7: 236–242
  • Kronenberg F, Fugh-Berman A. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Ann Intern Med 2002; 137: 805–813
  • Hirate JD S L, Zell B, Small R, Ettinger B. Does Dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertil Steril 1997; 68: 981–986
  • van der Laak J A, de Bie L M, de Leeuw H, de Wilde P C, Hanselaar A G. The effect of Replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry. J Clin Pathol 2002; 55: 446–451
  • Wu J P, Fielding S L, Fiscella K. The effect of polycarbophil gel (Replens) on bacterial vaginosis: a pilot study. Eur J Obstet Gynecol Reprod Biol 2007; 130: 132–136
  • Cicinelli E, Di Naro E, De Ziegler D, et al. Placement of the vaginal 17beta-estradiol tablets in the inner or outer one third of the vagina affects the preferential delivery of 17beta-estradiol toward the uterus or periurethral areas, thereby modifying efficacy and endometrial safety. Am J Obstet Gynecol 2003; 189: 55–58
  • Ayton R A, Darling G M, Murkies A L, et al. A comparative study of safety and efficacy of continuous low dose oestradiol released from a vaginal ring compared with conjugated equine oestrogen vaginal cream in the treatment of postmenopausal urogenital atrophy. Br J Obstet Gynaecol 1996; 103: 351–358
  • Henriksson L, Stjernquist M, Boquist L, Alander U, Selinus I. A comparative multicenter study of the effects of continuous low-dose estradiol released from a new vaginal ring versus estriol vaginal pessaries in postmenopausal women with symptoms and signs of urogenital atrophy. Am J Obstet Gynecol 1994; 171: 624–632
  • Nachtigall L E. Clinical trial of the estradiol vaginal ring in the US. Maturitas 1995; 22(Supp)S43–S47
  • Schmidt G, Andersson S B, Nordle O, Johansson C J, Gunnarsson P O. Release of 17-beta-oestradiol from a vaginal ring in postmenopausal women: pharmacokinetic evaluation. Gynecol Obstet Invest 1994; 38: 253–260
  • Casper F, Petri E. Local treatment of urogenital atrophy with an estradiol-releasing vaginal ring: a comparative and a placebo-controlled multicenter study. Vaginal Ring Study Group. Int Urogynecol J Pelvic Floor Dysfunct 1999; 10: 171–176
  • Barentsen R, van de Weijer P H, Schram J H. Continuous low dose estradiol released from a vaginal ring versus estriol vaginal cream for urogenital atrophy. Eur J Obstet Gynecol Reprod Biol, 19: 73–80
  • Smith P, Heimer G, Lindskog M, Ulmsten U. Oestradiol-releasing vaginal ring for treatment of postmenopausal urogenital atrophy. Maturitas 1993; 16: 145–154
  • Smith P. Estrogens and the urogenital tract. Studies on steroid hormone receptors and a clinical study on a new estradiol-releasing vaginal ring. Acta Obstet Gynecol Scand Suppl 1993; 157: 1–26
  • Henriksson L, Stjernquist M, Boquist L, Cedergren I, Selinus I. A one-year multicenter study of efficacy and safety of a continuous, low-dose, estradiol-releasing vaginal ring (Estring) in postmenopausal women with symptoms and signs of urogenital aging. Am J Obstet Gynecol 1996; 174: 85–92
  • Rigg L A, Milanes B, Villanueva B, Yen S S. Efficacy of intravaginal and intranasal administration of micronized estradiol-17beta. J Clin Endocrinol Metab 1977; 45: 1261–1264
  • Chaumeil J C. Micronization: a method of improving the bioavailability of poorly soluble drugs. Methods Find Exp Clin Pharmacol 1998; 20: 211–215
  • Fraser I S, Ayton R, Farrell E, Weisberg E, Darling G, Murkies A. A multicentre Australian trial of low dose estradiol therapy for symptoms of vaginal atrophy using a vaginal ring as delivery system. Maturitas 1995; 22(Supp)S41
  • Nilsson K, Heimer G. Low-dose oestradiol in the treatment of urogenital oestrogen deficiency – a pharmacokinetic and pharmacodynamic study. Maturitas 1992; 15: 121–127
  • Haspels A A, Luisi M, Kicovic P M. Endocrinological and clinical investigations in post-menopausal women following administration of vaginal cream containing oestriol. Maturitas 1981; 3: 321–327
  • Smith I E, Dowsett M. Aromatase inhibitors in breast cancer. N Engl J Med 2003; 348: 2431–2442
  • Kicovic P M, Cortes-Prieto J, Milojevic S, Haspels A A, Aljinovic A. The treatment of postmenopausal vaginal atrophy with Ovestin vaginal cream or suppositories: clinical, endocrinological and safety aspects. Maturitas 1980; 2: 275–282
  • Dugal R, Hesla K, Sordal T, Aase K H, Lilleeidet O, Wickstrom E. Comparison of usefulness of estradiol vaginal tablets and estriol vagitories for treatment of vaginal atrophy. Acta Obstet Gynecol Scand 2000; 79: 293–297
  • Electronic-Medicines-Compendium, Retrieved 25.07.2008 from: http://emc.medicines.org.uk/, 2008
  • Anderson J N, Peck E J, Jr, Clark J H. Estrogen-induced uterine responses and growth: relationship to receptor estrogen binding by uterine nuclei. Endocrinology 1975; 96: 160–167
  • Blum M. Benefits of vaginal estriol cream combined with clonidine HCl for menopausal syndrome treatment. Clin Exp Obstet Gynecol 1985; 12: 1–2
  • Blum M, Pery J, Gelenter I. Increase in glycosylated hemoglobin (HbA1c) in menopausal women treated with vaginal estrogen cream. Clin Exp Obstet Gynecol 1985; 12: 72–75
  • Mainini G, Scaffa C, Rotondi M, Messalli E M, Quirino L, Ragucci A. Local estrogen replacement therapy in postmenopausal atrophic vaginitis: efficacy and safety of low dose 17beta-estradiol vaginal tablets. Clin Exp Obstet Gynecol 2005; 32: 111–113
  • Manonai J, Chittacharoen A, Theppisai U. Transvaginal color Doppler sonographic assessment of uterus and ovaries in postmenopausal women: the effect of local estrogen treatment. Eur J Obstet Gynecol Reprod Biol 2006; 127: 222–226
  • Simunic V, Banovic I, Ciglar S, Jeren L, Pavicic Baldani D, Sprem M. Local estrogen treatment in patients with urogenital symptoms. Int J Gynaecol Obstet 2003; 82: 187–197
  • Rioux J E, Devlin C, Gelfand M M, Steinberg W M, Hepburn D S. 17beta-estradiol vaginal tablet versus conjugated equine estrogen vaginal cream to relieve menopausal atrophic vaginitis. Menopause 2000; 7: 156–161
  • Mettler L, Olsen P G. Long-term treatment of atrophic vaginitis with low-dose oestradiol vaginal tablets. Maturitas 1991; 14: 23–31
  • Manonai J, Theppisai U, Suthutvoravut S, Udomsubpayakul U, Chittacharoen A. The effect of estradiol vaginal tablet and conjugated estrogen cream on urogenital symptoms in postmenopausal women: a comparative study. J Obstet Gynaecol Res 2001; 27: 255–260
  • Weisberg E, Ayton R, Darling G, et al. Endometrial and vaginal effects of low-dose estradiol delivered by vaginal ring or vaginal tablet. Climacteric 2005; 8: 83–92
  • Notelovitz M, Funk S, Nanavati N, Mazzeo M. Estradiol absorption from vaginal tablets in postmenopausal women. Obstet Gynecol 2002; 99: 556–562
  • Bachmann G. The estradiol vaginal ring – a study of existing clinical data. Maturitas 1995; 22(Suppl)S21–S29
  • Naessen T, Rodriguez-Macias K. Endometrial thickness and uterine diameter not affected by ultralow doses of 17beta-estradiol in elderly women. Am J Obstet Gynecol 2002; 186: 944–947
  • Raymundo N, Yu-cheng B, Zi-yan H, et al. Treatment of atrophic vaginitis with topical conjugated equine estrogens in postmenopausal Asian women. Climacteric 2004; 7: 312–318
  • Manonai J, Theppisai U, Chittacharoen A. Effect and safety of 17 beta-estradiol vaginal tablet in postmenopausal women with urogenital symptoms. J Med Assoc Thai 2001; 84: 1015–1020
  • Luisi M, Franchi F, Kicovic P M. A group-comparative study of effects of Ovestin cream versus Premarin cream in post-menopausal women with vaginal atrophy. Maturitas 1980; 2: 311–319
  • BNF. Preparations for vaginal atrophy. British National Formulary. BMJ Publishing Group, London 2008; 419–420
  • Weiderpass E, Baron J A, Adami H O, et al. Low-potency oestrogen and risk of endometrial cancer: a case-control study. Lancet 1999; 353: 1824–1828
  • van Haaften M, Donker G H, Haspels A A, Thijssen J H. Oestrogen concentrations in plasma, endometrium, myometrium and vagina of postmenopausal women, and effects of vaginal oestriol (E3) and oestradiol (E2) applications. J Steroid Biochem 1989; 33(4A)647–653
  • Ganz P A, Greendale G A, Petersen L, Zibecchi L, Kahn B, Belin T R. Managing menopausal symptoms in breast cancer survivors: results of a randomized controlled trial. J Natl Cancer Inst 2000; 92: 1054–1064
  • Morales L, Neven P, Timmerman D, et al. Acute effects of tamoxifen and third-generation aromatase inhibitors on menopausal symptoms of breast cancer patients. Anticancer Drugs 2004; 15: 753–760
  • Vassilopoulou-Sellin R, Theriault R, Klein M J. Estrogen replacement therapy in women with prior diagnosis and treatment for breast cancer. Gynecol Oncol 1997; 65: 89–93
  • Key T, Appleby P, Barnes I, Reeves G. Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst 2002; 94: 606–616
  • Dowsett M, Folkerd E. Deficits in plasma oestradiol measurement in studies and management of breast cancer. Breast Cancer Res 2005; 7: 1–4
  • Jones M E, Folkerd E J, Doody D A, et al. Effect of delays in processing blood samples on measured endogenous plasma sex hormone levels in women. Cancer Epidemiol Biomarkers Prev 2007; 16: 1136–1139
  • Col N F, Hirota L K, Orr R K, Erban J K, Wong J B, Lau J. Hormone replacement therapy after breast cancer: a systematic review and quantitative assessment of risk. J Clin Oncol 2001; 19: 2357–2363
  • Col N F, Kim J A, Chlebowski R T. Menopausal hormone therapy after breast cancer: a meta-analysis and critical appraisal of the evidence. Breast Cancer Res 2005; 7: R535–R540
  • Batur P, Blixen C E, Moore H C, Thacker H L, Xu M. Menopausal hormone therapy (HT) in patients with breast cancer. Maturitas 2006; 53: 123–132
  • Antoine C, Liebens F, Carly B, Pastijn A, Neusy S, Rozenberg S. Safety of hormone therapy after breast cancer: a qualitative systematic review. Hum Reprod 2007; 22: 616–622
  • Biglia N, Cozzarella M, Cacciari F, et al. Menopause after breast cancer: a survey on breast cancer survivors. Maturitas 2003; 45: 29–38
  • Bachmann G, Lobo R A, Gut R, Nachtigall L, Notelovitz M. Efficacy of low-dose estradiol vaginal tablets in the treatment of atrophic vaginitis: a randomized controlled trial. Obstet Gynecol 2008; 111: 67–76
  • Long C Y, Liu C M, Hsu S C, Chen Y H, Wu C H, Tsai E M. A randomized comparative study of the effects of oral and topical estrogen therapy on the lower urinary tract of hysterectomized postmenopausal women. Fertil Steril 2006; 85: 155–160
  • Santen R J, Pinkerton J V, Conaway M, et al. Treatment of urogenital atrophy with low-dose estradiol: preliminary results. Menopause 2002; 9: 179–187
  • Foster D C, Palmer M, Marks J. Effect of vulvovaginal estrogen on sensorimotor response of the lower genital tract: a randomized controlled trial. Obstet Gynecol 1999; 94
  • Casper F, Petri E, Benninghoff B. [Continuous, low dosage estradiol administration with a vaginal ring: a placebo-controlled study]. Zentralbl Gynakol 1998; 120: 449–453
  • Eriksen P S, Rasmussen H. Low-dose 17 beta-estradiol vaginal tablets in the treatment of atrophic vaginitis: a double-blind placebo controlled study. Eur J Obstet Gynecol Reprod Biol 1992; 44: 137–144
  • Mattsson L A, Cullberg G, Eriksson O, Knutsson F. Vaginal administration of low-dose oestradiol – effects on the endometrium and vaginal cytology. Maturitas 1989; 11: 217–222
  • Wesel S, Etienne J, Lestienne M C. Clinical, cytological and biological study of the intra-vaginal administration of oestriol (Ortho-Gynest) in post-menopausal patients. Maturitas 1981; 3: 271–277

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.