engleski

Vaginal ERT: The Therapeutic Standard for Uro-genital Aging?

Objective: To determine the efficacy and safety of low dose (25  g) micronized 17  -estradiol administered vaginally in the management of patients with urogenital symptoms. Method: A total of 1612 patients with urogenital complaints were randomized to receive 25  g of micronized 17 -estradiol (828) or placebo (784) in a multicentric double-blind placebo controlled study running for 12 months. The women were treated once a day for two weeks, and then twice a week for the rest of the twelve months with the active or placebo tablet. The assessment included full history-questionnaire, micturition diary, gynecological and cystometric examination, transvaginal ultrasound and serum estradiol level determination. It was carried out at the beginning, and after four and twelve months of treatment. Result: The overall success rate of micronized 17 -estradiol on subjective and objective symptoms of postmenopausal women with vaginal atrophy was 85.5%, and the effect of placebo was 41.4%. A significant improvement of urinary atrophy symptoms was determined in vaginal ERT group comparing with the beginning of the study (51.9% vs. 15.5%, p=0.001). Maximal cystometric capacity and the volume of the urinary bladder at which patients first felt urgency and strong desire to void were considerably larger after micronized 17 -estradiol treatment than before it. The number of patients with uninhibited bladder contractions significantly decreased after micronized 17 -estradiol compared with the values before the treatment or after placebo. Side effects were observed in 61 (7.8%) patients treated with low dose micronized 17- estradiol. We found that 25  g of micronized 17- estradiol do not raise serum estrogen level and do not stimulate endometrial growth. Conclusion: Local administration of 25  g of micronized 17- estradiol is effective and safe treatment option in the management of women with urogenital complaints

urogenital atrophy; vaginal ERT

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