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FORT LAUDERDALE, FLA. -- Topical estrogen is important to the success of treatment for urogenital atrophy and also has therapeutic value for the management of urinary urgency, frequency, and, most importantly, nocturia, Dr. G. Willy Davila said at a symposium on pelvic floor disorders sponsored by the Cleveland Clinic Florida.
However, overcoming the fears of patients and oncologists about the safety of localized estrogen remains an uphill battle, said Dr. Davila, chairman of the department of gynecology, urology, and reconstructive pelvic surgery at the Cleveland Clinic Florida, Weston.
"Our task is to allay the fears of patients who come in and have this almost paranoid fear of any estrogen therapy. The main challenge is having the patient be compliant with therapy," he said.
Patients may be concerned that any form of estrogen might get into the bloodstream. But with vaginal estrogen, the dosage can be tailored so that it is not absorbed systemically, with the result that blood levels of estrogen are negligible, Dr. Davila said.
If vaginal atrophy is not treated, it will progress; advanced urogenital atrophy with increasing degrees of labial ...