Issue: November 2015
October 01, 2015
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Women more willing to use vaginal estrogen in tablet form compared with cream

Issue: November 2015
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Menopausal women with genitourinary symptoms are more likely to use vaginal estrogen treatment and to stick with treatment longer when it comes in tablet form compared with cream, according to recent study findings presented at The North American Menopause Society Annual Meeting.

“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,” Israel Yoles, MD, of Clalit Health Services in Israel, told Endocrine Today. “There is an urgent needs for for joint action between physicians, women and the media in order to raise awareness toward local treatments for postmenopausal women.”

Israel Yoles

Israel Yoles

Yoles and colleagues analyzed the local estrogen use of 21,422 Israeli women from the Central District of Clalit Health Services between 2006 and 2014. Treatment compliance was defined as an average interval between prescriptions of less than 4 months; adherence to treatment was defined as following the treatment regimen during the entire study period. Women classified as “sporadic” users (filling fewer than four prescriptions) were not included in the analysis (n = 17,648).

Of the 3,774 women eligible for analysis, 2,269 used a single type of estrogen therapy (mean age, 59 years); 487 using vaginal tablets and 1,782 using vaginal cream. In the tablet group, 64% were compliant with treatment vs. 39% in the vaginal cream group. Women who were compliant with treatment in the tablet group also adhered to treatment longer, for an average of 1,002 days vs. an average of 787 days for the vaginal cream group.

Wulf Utian , MD, PhD, DSc, executive director of The North American Menopause Society, noted that the study also revealed that use of local estrogens by postmenopausal women continues to be low, with only 5% of the women older than 50 years repeatedly using any kind of local estrogen.

“More research is needed to determine if this low usage rate is because of women’s perceptions or because many clinicians favor a more systemic hormone therapy approach,” Utian said in the press release.

“Although a majority of women suffer of some degree of genitourinary symptoms of menopause, most of them are not treated,” Yoles said. “It is probably due to the fact that postmenopausal women complain of vaginal symptoms only if asked directly. Future studies should explore the reason for the low percentage of treated patients.” – by Regina Schaffer

Reference:

Yoles I, et al. S-10. Presented at: The North American Menopause Society Annual Meeting; Sept. 30-Oct. 3, 2015; Las Vegas.

Disclosure: Yoles reports no relevant financial disclosures.