SGS: Local Estrogen For Genitourinary Complaints in Post-Menopausal Women

Project Summary Title and Description

SGS: Local Estrogen For Genitourinary Complaints in Post-Menopausal Women
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.
Authors of Report
Methodology description
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. Searched to April 2013
Data entered prospectively. Published as: Rahn DD, Carberry C, Sanses TV, Mamik MM, Ward RM, Meriwether KV, Olivera CK, Abed H, Balk EM, Murphy M; Society of Gynecologic Surgeons Systematic Review Group. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014 Dec;124(6):1147-56. doi: 10.1097/AOG.0000000000000526. PMID 25415166.
Funding Source
Society for Gynecologic Surgeons

Key Questions

1. For postmenopausal women with genitourinary complaints (including urinary incontinence, overactive bladder, recurrent UTI, vaginal irritation or dryness, sexual dysfunction/dyspareunia, or vaginal prolapse), what are the benefits and risks associated with vaginal estrogen application?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

Local estrogen treatment in patients with urogenital symptoms.2003
Randomized trial of estradiol vaginal ring versus oral oxybutynin for the treatment of overactive bladder.2011
Effective treatment of vaginal atrophy with an ultra-low-dose estradiol vaginal tablet.
Endometrial and vaginal effects of low-dose estradiol delivered by vaginal ring or vaginal tablet.2005
The effect of estradiol vaginal tablet and conjugated estrogen cream on urogenital symptoms in postmenopausal women: A comparative study2001
Influence of raloxifene on the efficacy of an estradiol-releasing ring for treating vaginal atrophy in postmenopausal women.2003
The use of oestradiol therapy in postmenopausal women after TVT-O anti-incontinence surgery.2010
Continuous low dose estradiol released from a vaginal ring versus estriol vaginal cream for urogenital atrophy.1997
The use of two estrogen preparations (a combined contraceptive pill versus conjugated estrogen cream) intravaginally to treat urogenital symptoms in postmenopausal Thai women: a comparative study.1998
Efficacy of low-dose intravaginal estriol on urogenital aging in postmenopausal women.2004
Transdermal estrogen with a levonorgestrel-releasing intrauterine device for climacteric complaints versus estradiol-releasing vaginal ring with a vaginal progesterone suppository: clinical and endometrial responses.1997
Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study.2010
The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis: a randomized controlled trial.2011
Plasma estrogen concentrations after oral and vaginal estrogen administration in women with atrophic vaginitis.
Effect of raloxifene on the response to conjugated estrogen vaginal cream or nonhormonal moisturizers in postmenopausal vaginal atrophy.
Clinical trial of the estradiol vaginal ring in the U.S.1995
The treatment of postmenopausal vaginal atrophy with Ovestin vaginal cream or suppositories: clinical, endocrinological and safety aspects.1980
Efficacy and safety of low-dose regimens of conjugated estrogens cream administered vaginally.2009
Histologic and cytologic effects of vaginal estrogen in women with pelvic organ prolapse: a randomized controlled trial.2013
Vaginal estrogen therapy and overactive bladder symptoms in postmenopausal patients after a tension-free vaginal tape procedure: a randomized clinical trial.2005
A randomized, open, parallel-group study on the preventive effect of an estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections in postmenopausal women.
A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections.1993
Efficacy of low-dose estradiol vaginal tablets in the treatment of atrophic vaginitis: a randomized controlled trial.
Estradiol absorption from vaginal tablets in postmenopausal women.2002
Urethral sphincteric insufficiency in postmenopausal females: treatment with phenylpropanolamine and estriol separately and in combination. A urodynamic and clinical evaluation.1984
The therapeutic effect of a new ultra low concentration estriol gel formulation (0.005% estriol vaginal gel) on symptoms and signs of postmenopausal vaginal atrophy: results from a pivotal phase III study.2012
Effectiveness of estriol-containing vaginal pessaries and nitrofurantoin macrocrystal therapy in the prevention of recurrent urinary tract infection in postmenopausal women.2003
Low dose estriol pessaries for the treatment of vaginal atrophy: a double-blind placebo-controlled trial investigating the efficacy of pessaries containing 0.2mg and 0.03mg estriol.2012
Preoperative treatment with oestradiol in women scheduled for vaginal operation for genital prolapse. A randomised, double-blind trial.1992
Clinical effects of preoperative oestradiol treatment before vaginal repair operation. A double-blind, randomized trial.1995
The effect of transdermal and vaginal estrogen therapy on markers of postmenopausal estrogen status.2008
Efficacy of estradiol vaginal cream in postmenopausal women.1979
Comparative study: Replens versus local estrogen in menopausal women.1994
Comparison of usefulness of estradiol vaginal tablets and estriol vagitories for treatment of vaginal atrophy.2000
Is there a synergistic effect of topical oestrogens when administered with antimuscarinics in the treatment of symptomatic detrusor overactivity?2009
Vaginal ultrasound of the endometrium in postmenopausal women with symptoms of urogenital atrophy on low-dose estrogen or tibolone treatment: a comparison.1997
Randomized comparison of tolterodine with vaginal estrogen cream versus tolterodine alone for the treatment of postmenopausal women with overactive bladder syndrome.2009
Effects of intravaginal estriol and pelvic floor rehabilitation on urogenital aging in postmenopausal women.
A randomized comparative study of the effects of oral and topical estrogen therapy on the lower urinary tract of hysterectomized postmenopausal women.2006
A randomized comparative study of the effects of oral and topical estrogen therapy on the vaginal vascularization and sexual function in hysterectomized postmenopausal women.2006
17beta-estradiol vaginal tablet versus conjugated equine estrogen vaginal cream to relieve menopausal atrophic vaginitis.2000
Oestradiol-releasing vaginal ring versus oestriol vaginal pessaries in the treatment of bothersome lower urinary tract symptoms.2000
A Comparative study of low-dose estradiol vaginal ring and conjugated estrogen cream for postmenopausal urogenital atrophy197
A comparative study of the effects of local estrogen with or without local testosterone on vulvovaginal and sexual dysfunction in postmenopausal women.2010
Low-dose 17 beta-estradiol vaginal tablets in the treatment of atrophic vaginitis: a double-blind placebo controlled study.1992
A randomized clinical trial of the impact of local estrogen on postoperative tissue quality after vaginal reconstructive surgery.2012
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.1996
Long-term treatment of atrophic vaginitis with low-dose oestradiol vaginal tablets.1991
Estrogen therapy influence on periurethral vessels in postmenopausal incontinent women using Dopplervelocimetry analysis.2008
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.1994
Vaginal administration of low-dose oestradiol--effects on the endometrium and vaginal cytology.1989
A clinical evaluation of treatment with estriol vaginal cream versus suppository in postmenopausal women.1983
Vaginal rings for continuous low-dose release of oestradiol in the treatment of urogenital atrophy.1989
Ovestin vaginal cream and suppositories for the treatment of menopausal vaginal atrophy.1982
Vaginal oestradiol for the treatment of lower urinary tract symptoms in postmenopausal women--a double-blind placebo-controlled study.2001
Twice-weekly synthetic conjugated estrogens vaginal cream for the treatment of vaginal atrophy.-- Not Found --

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