Evidence Summary
What is an Evidence Summary?
Key messages from scientific research that's ready to be acted on
Got It, Hide thisIn women who have genitourinary syndrome of menopause, vaginal estrogens reduce symptoms and do not cause side effects
Rahn DD, Carberry C, Sanses TV, et al. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014;124:1147-56.
Review questions
In postmenopausal women who have genitourinary syndrome of menopause, do vaginal estrogens reduce symptoms? Do they cause side effects?
Background
Genitourinary syndrome of menopause is a group of signs and symptoms that can affect the genital system (vaginal dryness or burning, and pain during sexual intercourse) and the lower urinary tract (increased frequency of urination, urgency to urinate, and pain while urinating). About half of postmenopausal women experience genitourinary syndrome, which does not improve without treatment.
How the review was done
The researchers did a systematic review of studies that were published up to April 2013.
They found 44 studies.
Key features of the studies were:
- the treatment was vaginal estrogen delivered by tablet, cream, gel, ring, ovule, or suppository;
- vaginal estrogen was compared with placebo or no treatment (14 studies with 4,232 women), another vaginal estrogen, systemic estrogen, nonhormonal moisturizer or lubricant, or other treatments; and
- studies were 1 month to 1 year long.
What the researchers found
The quality of evidence varied. Findings for comparisons and outcomes that are based on moderate-strength evidence are reported here. Evidence of poor, low, or very low-quality is not reported here.
Compared with placebo or no treatment, vaginal estrogen:
- reduced the frequency of urinary tract infections;
- reduced vaginal dryness, itching or burning, and painful intercourse;
- reduced urinary incontinence; and
- did not increase risk for side effects.
Conclusion
In women who have genitourinary syndrome of menopause, vaginal estrogens reduce symptoms and do not cause side effects.
Effects of vaginal estrogen compared with placebo or no treatment on genitourinary syndrome symptoms in menopausal women
| Outcomes | Effects of vaginal estrogen |
| Urinary tract infection | 4 studies found that frequency of urinary tract infections was decreased with estrogen |
| Vaginal dryness, itching or burning, and painful intercourse | 9 studies found that dryness improved with estrogen (2 found it did not) 6 studies found that itching or burning improved with estrogen (5 found it did not) 9 studies found that painful intercourse improved with estrogen (1 found it did not) |
| Urgency urinary incontinence | 3 studies found that urgency urinary incontinence improved with estrogen |
| Side events | 13 trials reported no difference in adverse events between women treated with estrogen and women treated with placebo |
Related Topics
Glossary
A harmless, inactive, and simulated treatment.
A comprehensive evaluation of the available research evidence on a particular topic.
Related Evidence Summaries
-
Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women
Cochrane Database of Systematic Reviews (2011) -
Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse.
Cochrane Database Syst Rev (2016) -
Screening for prostate cancer
Cochrane Database of Systematic Reviews (2013)
Register for free access to all Professional content
RegisterOur Content
About
Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.
