Effects of vaginal estrogen therapy on urogenital atrophy: comparison of three doses

Background and aims: Problems associated with vaginal atrophy affect up to 60% of postmenopausal women. This study aimed to evaluate the effect of vaginally administered estrogen on
urogenital atrophy symptoms and compare the outcomes between three different doses of vaginal
estrogen to find the optimal dosage without an effect on endometrial thickness.
Material and methods:51 Menopausal women with vaginal atrophy were randomly assigned into
three study groups receiving 0.5gr of vaginal estrogen cream, which contains 0.625 mg/gram once a
week, twice a week and three times a week for six months. Questionnaires were completed once
before the intervention and once at the end of the 6 month follow-up.
Results: Significant relief of dyspareunia was found in all three groups with the highest improvement
(69.2%) reported by women in group 2. Frequency of intercourse was significantly increased after the
treatment in groups 2 and 3. Respondents in groups 2 and 3 reported a significantly improved couple
intimacy and marital relation. Regarding the urinary symptoms, only urine frequency was relived
significantly in groups 2 and 3 while urinary incontinency and dysuria did not differ before and after
the treatment.
Conclusion: vaginal estrogen therapy is effective in improving dyspareunia and thus sexual function;
however its impact on urinary complaints of urogenital needs further investigation. Between the three
studied doses, 0.5 gr vaginal estrogen twice a week was shown to be optimal since 0.5 gr once a week
was obviously inadequate while 0.5 gr three times a week was unnecessary.