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Vaginal administration of low-dose conjugated estrogens: systemic absorption and effects on the endometrium.

AbstractOBJECTIVE:
To test the hypothesis tha a very-low-dose regimen of vaginal estrogen would provide effective relief from atrophic vaginitis without endometrial proliferation.
METHODS:
Twenty postmenopausal women with symptoms, signs, and cytologic evidence of atrophic vaginitis were enrolled. Each subject was treated with 0.3 mg of conjugated estrogens, administered vaginally 3 nights per week for 6 months. We examined the following outcomes: symptoms, vaginal cellular (cytologic) maturity, endometrial histology, sonographic evaluation of endometrial thickness, Doppler measures of uterine artery blood flow, and serum levels of estrone and estradiol. Pre- and post-treatment data were compared for each subject.
RESULTS:
Satisfactory relief of symptoms occurred in 19 of 20 cases. Vaginal cellular maturation improved significantly with therapy (P < .01). There were no significant changes in endometrial thickness, uterine artery blood flow, or serum estrogen levels. Endometrial proliferation was observed in one case.
CONCLUSIONS:
Relief from atrophic vaginitis can be achieved with 0.3 mg of conjugated estrogens administered vaginally three times per week. Endometrial proliferation may occur at this low dose, albeit rarely.
AuthorsV L Handa, K E Bachus, W W Johnston, S J Robboy, C B Hammond
JournalObstetrics and gynecology (Obstet Gynecol) Vol. 84 Issue 2 Pg. 215-8 (Aug 1994) ISSN: 0029-7844 [Print] United States
PMID8041532 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Estrogens, Conjugated (USP)
  • Estrone
  • Estradiol
Topics
  • Administration, Intravaginal
  • Aged
  • Atrophy
  • Biopsy
  • Blood Flow Velocity (drug effects)
  • Cell Division (drug effects)
  • Endometrium (blood supply, drug effects, pathology, physiopathology)
  • Estradiol (blood)
  • Estrogens, Conjugated (USP) (administration & dosage, pharmacokinetics)
  • Estrone (blood)
  • Female
  • Humans
  • Middle Aged
  • Postmenopause
  • Rheology
  • Time Factors
  • Vaginitis (blood, drug therapy, pathology, physiopathology)

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