Most Read Articles
26 Oct 2020
During menopause, there is a decline in endogenous estrogen serum levels resulting in the atrophic changes of the genital tract and other estrogen-dependent tissues.1 About 45% of postmenopausal women experience vaginal atrophy and symptoms, such as pain during sex, itching, irritation, burning sensation and various urinary problems which includes increased frequency, urgency, dysuria and infection, that can greatly impact a patient’s quality of life, especially their sexual function.2 In addition, these symptoms do not resolve spontaneously hence, long-term therapy is necessary.1  

Ultra–low-dose estrogen therapy: A little goes a long way

26 Oct 2020
Currently available management for vaginal atrophy includes systemic or locally administered estrogen therapy. Current recommendations suggest the long-term use of local estrogen for symptom control. Vaginal estrogen tablet, in comparison with other local estrogen therapies, provides a more consistent dose of the hormone with greater patient adherence and lesser potential leakage.1

An ultra–low-dose vaginal estrogen therapy was introduced in 2010. This vaginal tablet contained estradiol 10 µg and was developed to reduce systemic exposure to estrogen while providing symptom relief. A multicenter, randomized double-blinded trial involving 309 postmenopausal women, >45 years of age, with at least three urogenital symptoms (ie, vaginal dryness, vaginal soreness, vulvar irritation, dysuria, dyspareunia) evaluated the efficacy and safety of ultra–low-dose estradiol 10 µg vaginal tablet.3 The grading of the vaginal health was evaluated using a 4-point system (0=no atrophy, mild=1, moderate=2, severe=3). The participants were asked to identify one symptom that was bothersome to them.  Results showed a significant improvement in the grading of vaginal health and vaginal pH (p<0.001) after 12 weeks of treatment. For the most bothersome symptoms, the effects of treatment became more apparent after 4 weeks and reached statistical significance at 8 weeks. There was also a maintained improvement of symptoms for up through 52 weeks of treatment.3 With regards to its safety, systemic absorption of estradiol was low with no evidence of increased risk of endometrial hyperplasia or carcinoma.1–3  

Vaginal atrophy is a common chronic condition that requires a safe, long-term therapy. Ultra–low-dose estrogen vaginal therapy provides sufficient estrogen that can greatly improve a patient’s quality of life by relieving symptoms of vaginal atrophy and reversing atrophic changes associated with menopause. It was found to be safe in clinical studies with limited systemic absorption in the body.  
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Most Read Articles
26 Oct 2020
During menopause, there is a decline in endogenous estrogen serum levels resulting in the atrophic changes of the genital tract and other estrogen-dependent tissues.1 About 45% of postmenopausal women experience vaginal atrophy and symptoms, such as pain during sex, itching, irritation, burning sensation and various urinary problems which includes increased frequency, urgency, dysuria and infection, that can greatly impact a patient’s quality of life, especially their sexual function.2 In addition, these symptoms do not resolve spontaneously hence, long-term therapy is necessary.1