New study demonstrates preference for vaginal estrogen tablets vs. cream and how method of treatment affects adherence to treatment
Local estrogens continue to be underutilized in the treatment of genitourinary symptoms of menopause, including vaginal dryness, painful intercourse and urinary tract infections. That has been proven by numerous prior studies. However, a new study coming out of Israel documents that the method of local treatment has a dramatic effect on how long women continue the treatment and adhere to treatment guidelines. The study, "Local Estrogens for Genitourinary Symptoms of Menopause. Does the Method of Treatment (Tablets or Cream) Change the Compliance and Adherence to Treatment?," will be presented at the 2015 Annual Meeting of The North American Menopause Society (NAMS) in Las Vegas starting on September 30.
The authors of the study analyzed data on the use of vaginal tablets and vaginal cream over a nine-year period. The study looked at a total of 21,400 Israeli women to analyze their preferred method of treatment, as well as the length of time they continued the treatment. Women described as sporadic users (those who did not utilize more than a total of four prescriptions) represented 82% of the total. Sixty percent (60%) of the women remained with one therapy over time and 40% switched between treatments.
While more women (79%) used the cream, those women taking the tablets were more likely to comply with the suggested regimen for a longer period of time--an average of 1002 days as compared to 787 days for the cream.
"Since both treatment options are comparable in the results they produce, this study sends a strong message to physicians to consider an alternative treatment method that women prefer and might follow longer," says Dr. Israel Yoles of Clalit Health Services in Israel who served as the lead author for the study. "While cream is more commonly prescribed, the end results are likely to be better with tablets because they are more often being taken as directed."
Dr. Wulf Utian, NAMS executive director, noted that another key finding of the study is that the usage of local estrogens, in general, by postmenopausal women continues to be extremely low, with only 5% of the women over 50 years of age 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," says Utian.