Estrogen Treatment Method for Genitourinary Symptoms Affects Adherence

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Women demonstrate preference for oral estrogens for genitourinary menopausal symptoms.

Although more women used vaginal cream for genitourinary menopausal symptoms, including vaginal dryness, painful intercourse, and urinary tract infections, results of a new study suggest that women were more likely to use vaginal tablets for a longer duration.

“Women who used vaginal tablets compared to cream were more compliant to treatment regimens as directed and used it, on average, half a year longer,” Israel Yoles, MD, lead study author and head of gynecological services for the Central District of Clalit Health Services, Israel, told Endocrinology Advisor

The study was presented at NAMS 2015, the North American Menopause Society Annual Meeting in Las Vegas.

According to Dr Yoles, the goal of the study was to compare two methods of local estrogen treatment — vaginal tablets and vaginal cream — for genitourinary menopausal symptoms.

In all, Dr Yoles and colleagues analyzed data on 21,400 Israeli women to determine their preferred treatment method, as well as the length of treatment duration.

Data indicated that 82% of women were sporadic users, defined as not utilizing more than four prescriptions; 60% remained on one therapy; and 40% switched between treatments.

In addition, despite more women using cream (79%), women taking tablets complied with the suggested regimen for a longer duration (1,002 days vs. 787 days).

Dr Yoles added that, in general, the usage of local treatments was extremely low and that, surprisingly, more than half of the 91 gynecologists in the district never prescribed even one local treatment.

“Since compliance and adherence is different between the two modes of administration, physicians should be aware of the patient’s preference and prescribe treatment accordingly,” Dr Yoles said. “There is an urgent need for a conjoint action between physicians, women, and the media to raise the awareness toward local treatments for postmenopausal women.”


  1. Yoles I et al. Local Estrogens for Genitourinary Symptoms of Menopause. Does the Method of Treatment (Tablets or Cream) Change the Compliance and Adherence to Treatment? Presented at: The North American Menopause Society (NAMS) Annual Meeting; Sept. 30-Oct. 3, 2015; Las Vegas.